Authors: David Grant
The NSW State Insurance Regulatory Authority (SIRA) has implemented avalue-based health care approach to transforming the delivery of healthcare within the personal injury schemes for NSW. SIRA’s Implementation Plan for Value-Based Health Care in NSW WC and CTP Schemes (the Implementation Plan), released in December 2021, sets out 21 initiatives under four work streams:
Stream 1: Measure health outcomes and costs and improve data quality
Stream 2: Support enhanced clinical practice
Stream 3: Streamline administration and reduce leakage
Stream 4: Develop scheme capability in VBHC.
The poster explores SIRA’s transition to value-based health care, governance arrangements and key achievements, this includes:
- Establishment of a sector-wide Value-Based Health Care Advisory Committee to provide advice and support our vision for health care. The Value-Based Health Care Advisory Committee comprises key senior leaders in insurance, health care delivery, employers, academia, and people with lived experience.
- an observed stabilisation of health care expenditure growth in the last two financial years after COVID.- Implementation of surgeon and allied health fee reforms which are one track to deliver projected savings in the workers compensation scheme for financial year 2022-23.
- In partnership with the NSW Agency for Clinical Innovation, development of a new model of care for low back pain, which will benefit over 18,000 people with low back pain that enter the personal injury schemes each year.
- Development of a new approach to allied health treatment approval to reduce administrative burden for health providers and insurers and increase focus on clinical care.
- Publication of a range of standardised outcome measures for health providers to screen an injured person’s health status to optimise care pathways in the personal injury schemes.
- Design of new data systems to identify billing practice compliance, including overcharging and over-servicing.
- Obtained new legislative powers to regulate health providers who are not doing the right thing.