FBE HALE Hub

​The problem​

The escalating cost of healthcare and the need for an efficient and equitable healthcare system is a pressing issue globally. In Australia, healthcare funding often hinges on service volume rather than health outcomes, leading to escalating costs, inequitable and inefficient care.

While policymakers are exploring innovative approaches, such as team-based care and value-based funding, the lack of robust evidence hinders effective policy development.

The research​​

HALE Hub aims to provide this much-needed evidence through rigorous analyses of key policy reforms and the integration of advanced data analytics and artificial intelligence (AI) techniques.

Pivotal policy reforms that HALE Hub are evaluating include:

• The tripling of bulk-billing incentives for General Practitioners (GPs) and making healthcare more affordable
• The Pharmaceutical Benefits Scheme (PBS) Safety Net and co-payment reductions
• The Closing-the-Gap (CTG) co-payment measure ($335 million) and Indigenous Practice Incentives Program
• The National Disability Insurance Scheme (NDIS) roll-out in 2016-2018.
• The introduction of public reporting of five-star quality ratings in 2022 and activity-based funding for residential aged care in 2023.
• Women’s healthy aging.
• Uncover “hidden” waiting times.

Through this research, by a multidisciplinary team of researchers from across the University of Melbourne, Australian and overseas universities, and other Stakeholders, the Hub will provide policymakers with insights that can usher in a more efficient, equitable, and sustainable healthcare system in Australia.

Using cutting-edge methods in machine learning and an extensive dataset spanning 15 years for the entire Australian population (Person-Level Integrated Data Asset [PLIDA]), HALE Hub represents a groundbreaking endeavour in this space.

The impact​​

With a mission to provide vigorous research that drives effective and much needed policy development, HALE Hub is on track.

Between roundtable discussions with policymakers and executive industry leaders, and meetings with international government agencies, findings are being widely disseminated with advice implemented by decision-makers.

Their evaluation on the effects of major government incentive policies on private health insurance uptake and use of public and private hospitals, for example, has provided crucial insights into the complex interplay between public and private healthcare financing in Australia. One particular proposal the government was evaluating, which would require people to buy more expensive plans to avoid Medicare Levy surcharge, was dropped after considering the team’s research, which did not support the change.

Educating the public about government tax and rebate incentives and how to reform private health insurance has been achieved through the publication of mainstream media articles including in The Conversation.

Several external grant and contract successes are helping to progress various areas of the Hub’s research agenda. This includes two research contracts with the Eastern Melbourne Primary Health Network to evaluate their new primary care support model. An MRFF frontier EOI with cancer researchers has also been submitted and is awaiting outcome.

HALE Hub researcher Karinna Saxby received a McKenzie Postdoctoral Fellowship, to work on the project “Community attitudes and mental health inequalities in priority populations”.

And several of the team (Yuting Zhang, Ou Yang, Ron Fischer, Karinna Saxby, Jongsay Young) are undertaking a review of foster care funded by the Independent Pricing and Regulatory Tribunal (IPART) of New South Wales. The final report – IPART out-of-home care review: Cost of Caring provided much needed evidence-based recommendations for providing quality foster care.

Spreading the research findings and gathering interest more broadly, HALE Hub researchers have published, and had accepted, multiple new journal papers. These include: Waiting times for psychiatric specialist services in Australia in JAMA Network Open; Geographic variation in bulk billing rates and out-of-pocket costs for General Practitioner services: evidence from whole-of-population Medicare data in Medical Journal of Australia; Community attitudes and Indigenous Health Disparities: Evidence from Australia’s Voice Referendum in The Lancet Regional Health - Western Pacific; Structural stigma and sexual orientation disparities in long-term health conditions: Evidence from the Australian Census in American Journal of Public Health; Financial incentives and private health insurance demand on the extensive and intensive margins in Journal of Health Economics; and Effects of Private Health Insurance on Waiting Time in Public Hospitals in Health Economics.

The findings are also reaching a general audience through frequent outreach, media interviews and several features in The Conversation. Published articles span waiting times for psychiatry appointments to bulk billing ( why not all GPs do , and where the major parties sit on the topic), the cost of specialist appointments and the impact of private health insurance offering telehealth, to the relationship between Indigenous health and opposition to the Voice.

Department: Melbourne Institute
Area: Health, policy

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