JANUARY

What is being done to reduce disparities?
AUSTRALIA
The most prominent disparities in health outcomes are between the Aboriginal and Torres Strait Islander
population and the rest of Australia’s population; these are widely acknowledged as unacceptable. In 2008, the
COAG agreed to a target date of 2031 for closing the gap in life expectancy. Its strategy goes beyond health
care, seeking to address disparities in other areas such as education and housing. The Prime Minister makes an
annual statement to Parliament on progress toward closing the gap.
Disparities between major urban centers and rural and remote regions and across socioeconomic groups are
also major challenges. The federal government provides incentives to encourage GPs and other health workers
to work in rural and remote areas, where it can be very difficult to attract a sufficient number of practitioners.
This challenge is also addressed to an extent through the use of telemedicine. Since 1999, the Australian
Government has funded the Public Health Information Development Unit (www.publichealth.gov.au) for the
purpose of publishing small-area data showing disparities in access to health services and health outcomes on
a geographic and socioeconomic basis.
What is being done to promote delivery system integration and
care coordination?
Approaches to improving integration and care coordination include the PIP, which provides a financial incentive
to providers for the development of care plans for patients with certain conditions, such as asthma, diabetes,
and mental health needs. The PHNs were established in July 2015 with the objective of improving coordinated
care, as well as the efficiency and effectiveness of care for those at risk of poor health outcomes. These
networks are funded through grants from the federal government and will work directly with primary care
providers, health care specialists, and LHNs. Care also may be coordinated by Aboriginal health and community
health services.
What is the status of electronic health records?
The National eHealth Transition Authority has been working to establish interoperable infrastructure to support
communication across the health care system. A national e-health program based on personally controlled
unique identifiers has commenced operation in Australia, and 2.5 million patients and nearly 8,000 providers
have registered (DH, 2015a). The record supports prescription information, medical notes, referrals, and
diagnostic imaging reports. Following a review, government is taking a number of steps to increase uptake by
both patients and providers, which has been poor to date, by improving usability, clinical utility, governance,
and operations. In addition, an opt-out approach will be tested to replace the current opt-in approach. The new
Australian Commission for eHealth will begin oversight in July 2016, taking on the e-health roles of the
Department of Health and the National eHealth Transition Authority. The current PIP eHealth Incentive, which
aims to encourage GPs to participate, also will be reviewed for potential improvements.
How are costs contained?
The major drivers of cost growth are the MBS and PBS. Government regularly considers opportunities to reduce
spending growth in the MBS through its annual budget process and has established an expert panel to
undertake a review of the entire schedule and report by the end of 2016.
Government influences the cost of the PBS in making determinations about what pharmaceuticals to list on the
scheme and in negotiating the price with suppliers. Government provides funds to pharmacies for dispensing
medicines subsidized through the PBS and to support professional programs and the wholesale supply of
medicines. This arrangement is through the current Community Pharmacy Agreement (the Community
Pharmacy Agreements were instituted in 1991 and are subject to renegotiation every five years). The Sixth
Community Pharmacy Agreement, which began in July 2015, supports AUD6.6 billion (USD4.3 billion) in savings
through supply chain efficiencies (Ley, 2015).
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