Authors:Henry Cutler1, Mona Aghdaee1, Olukorede Abiona1, Yuanyuan Gu1, Dandan Yu1
Affiliations:
- Macquarie University Centre for the Health Economy, Australian Institute of Health Innovation, Macquarie University Business School, Macquarie University, Sydney, NSW, Australia.
The following is a summary of an oral presentation at the 2025 AHES Conference: https://ahes.org.au/wp-content/uploads/2025/09/AHES-Annual-Conference-2025-Abstracts-Booklet_final.pdf
In recent decades, value-based care has become a central healthcare reform strategy, shifting the focus of health systems from service volume to patient-centred outcomes, care quality, and experience. Value-based healthcare refers to the allocation and delivery of services that maximise patient health outcomes relative to the resources used. The underlying aim is to improve population-level outcomes and health system efficiency simultaneously.
In Australia, all states and territories are increasingly embedding value-based healthcare principles to guide funding, service design, and performance measurement. However, despite this policy momentum, what constitutes “value” may be interpreted differently by patients, clinicians, the public and policy makers. For some, it is about efficiency and cost control, for others, it is about improving outcomes or experiences.
Our study explored how the Australian public defines “value” in healthcare. Using a choice experiment, we asked participants to weigh seven attributes of care, including outcomes, efficiency, timeliness, and unintended harm, to reveal what they value most.
The results show that Australians place the greatest value on health outcomes and the likelihood that services will deliver them. This points to a strong preference for reliability: people want confidence that promised outcomes will be achieved. Efficiency ranked third, suggesting cost-effectiveness matters, but only once desirable outcomes are guaranteed. Provider experience received the lowest weighting, suggesting that while the public recognises its importance, it is not something they are willing to trade off against their own health benefit (See Chart 1)
Chart 1. Relative importance of each attribute, simulated method
Note: This presents median values constructed using the simulation method. Relative importance values were scaled by a common factor to ensure that their sum equals 100.
Preferences varied across population groups. Older Australians prioritised outcomes and timeliness, while younger respondents valued efficiency. Those without recent care use placed more emphasis on care efficiency. Education, employment, and number of chronic conditions also shaped preferences.
Overall, our study results suggest that the public defines “value” primarily through outcomes and efficiency, rather than through broader frameworks that treat all attributes equally. For policymakers, this distinction is crucial. While reforms often balance patient outcomes, experience, cost, and provider wellbeing, the public clearly prioritises care features differently. Performance measurement and funding systems should place outcomes and reliability at the core to reflect public priorities. Efficiency is valued, but only once care is proven effective.
Provider experience remains essential. It drives high-quality care. However, it should be treated as a means to achieving value, not as a competing outcome. This calls for a more focused model of value-based care that measures success by the health improvements delivered per dollar invested, supported by a skilled and capable workforce. Aligning policy metrics with what matters most to the public will strengthen the credibility and impact of Australia’s value-based care agenda.
Source: Unsplash
