Beta We are building this new website to better deliver information. Learn more about this site.
Corporate Plan 2018-2019

Guaranteeing Medicare and improving access to medicines

To support the long term national health plan the Medicare Guarantee Fund was established along with restoration of indexation for Medicare and an increased investment in new medicines. Further initiatives will be implemented to make private health insurance simpler and more affordable.

This initiative aligns to department outcomes 1, 2, 4 & 6 in the Health Portfolio Budget Statements

Our aim

  • Improve the life of every Australian through a universal Medicare system.
  • Support bulk billing by health providers.
  • List new and effective medicines.
  • Provide a clinically effective and cost-effective Medicare that is protected against fraud and inappropriate practices.
  • Support continued access to cheaper safer therapeutic goods and information to better manage healthcare issues.
  • Improve access to life-saving and life-improving medicines and health products.
  • Provide simpler and more affordable Private Health Insurance for Australians.
  • Improve Indigenous health through access to high quality health services.
  • Improve patient care, and help the primary health care sector, including general practices and Aboriginal Community Controlled Health Services, to keep pace with the increasing demand for services.

Our challenges

  • Ensure the right medicines at the right price are available to patients when required.
  • Keep pace with rapidly developing technologies.
  • Ensure integrity and value for money of our health system and programs.

Our work to achieve this initiative

  • Continue to review the Medicare Benefits Schedule (MBS).
  • Listing of new medical services on the MBS, as recommended by the Medical Services Advisory Committee.
  • Improving Medicare compliance and debt recovery.
  • Providing earlier access to life-saving therapeutic goods by implementing new pathways such as provisional approval, priority review, and new orphan medicine criteria.
  • Implement the Private Health Insurance reforms to take effect from April 2019.
  • Improve the Pharmaceutical Benefits Scheme payment system.
  • Focus on delivery of services for Aboriginal and Torres Strait Islander people through the Indigenous Australians’ Health Programme.
  • Working with comparable overseas regulators to increase efficiencies in regulatory systems and processes.
  • Listing of new and innovative medicines on the Pharmaceutical Benefits Scheme, as recommended by the Pharmaceutical Benefits Advisory Committee.
  • Implementing a new primary health care funding model for the Indigenous Australians’ Health Programme.
  • Continuing the health protection and emergency response efforts to protect the health of the Australian community.
  • Continuing the implementation of the reforms arising from the Review of Medicines and Medical Devices Regulation – in particular advertising reforms and public education.
  • Targeting specific health matters affecting Aboriginal and Torres Strait Islander people and increasing cultural capability of the broader health workforce.
  • Ongoing monitoring of medicines and devices to ensure they remain safe and effective for all Australians.

Our role and that of our partners

  • We will continue to strengthen relationships with our stakeholders and work with health providers and hospitals to improve services.
  • We will invest in new technology to automate activities, providing more consistent and streamlined processes, reduced effort and improved decision making. 
  • We will build our internal capability to contribute to building an effective and equitable health system.
  • We continue to work closely with the National Aboriginal Community Controlled Health Organisation and Primary Health Networks on Aboriginal health and wellbeing issues. 

Management of identified risks

Key risks

Pressure on our ability to continue to provide a modern and sustainable Medicare program that supports all Australians to access high quality and cost-effective professional services and medicines that are in line with current clinical evidence.

Failure to complete the MBS review in a timely, efficient and effective manner.

Management strategies

To ensure we meet the Government's obligation to deliver a clinically and cost effective Medicare program and provide access to essential services, medicines and health products, we regularly engage with our key stakeholders, such as clinicians, consumers, private health insurers, pharmaceutical companies, pharmacists, and state and territory governments. The consultation and engagement techniques employed enable us to have visibility of stakeholder expectations and requirements. 

We are reviewing the more than 5,700 items on the MBS to align services with contemporary clinical practice and best available evidence to improve patient outcomes. The review also allows us to ensure a clinically effective and cost effective Medicare program so that the right services are available when required.

Measuring our performance against key measures

Performance measures

Continued review of MBS items to maintain a Medicare system that provides high value care to the Australian public based on contemporary evidence and practice.
Target 2018­–19

Clinical Committees will have considered 95 per cent or more of the MBS items.

Target 2019–22

Clinical Committees will have considered 100 per cent of the MBS items.

Ensuring access to innovative, clinically effective and cost effective medicines through the Pharmaceutical Benefits Scheme.
Target 2018–19

Eighty per cent of submissions for new medicines that are recommended for listing by the Pharmaceutical Benefits Advisory Committee are listed on the Pharmaceutical Benefits Scheme within six months of agreement of price.

Target 2019–22

As per 2018–19

Earlier access to new medical devices for Australian consumers and health professionals.
Target 2018–19

Increased flexibility in pre-market assessment processes, including a process for expedited approval in certain circumstances.

Target 2019–22

As per 2018–19.

Audits and reviews are targeted effectively to those providers whose claiming is non-compliant, so that the following proportions of audits and reviews find non-compliance.
Target 2018–19

Greater than 90 per cent.

Target 2019–22

As per 2018–19.

Last updated: 
20 November 2018