Centre Events
Part of the role of MUCHE is to provide forums that enhance debate and enable people to share ideas.
These events include educational seminars, roundtables and issues forums. Some of the most recent events have included the discussion on the impact of Competition Policy in Health, measuring social care related quality of life (SCRQOL) in aged care and strengthening partnerships with Government.
Upcoming Events
Payment and economic evaluation - April 14, 2025
Associate Professor Apostolos Tsiachristas, University of Oxford
As health systems grapple with the growing burden of chronic diseases, the integration of care has emerged as a key strategy to improve outcomes and control costs. This seminar explores how payment models can be leveraged to enable integrated care and how robust evaluation frameworks can guide investment and disinvestment decisions. Drawing on European case studies and recent empirical evidence, Prof. Tsiachristas will discuss alternative payment schemes—such as bundled payments and population-based models—and their role in aligning incentives across sectors. The session also introduces a practical, value-based evaluation framework using Multi-Criteria Decision Analysis (MCDA) to support prioritization in Integrated Care Systems (ICS), in England
Value-based care: how do we measure and assess value? - April 16, 2025
Associate Professor Apostolos Tsiachristas, University of Oxford
Over the last 20 years, the National Health Service (NHS) in England has introduced several policy reforms aiming at promoting integrated care, having as cornerstone the recent establishment of 42 Integrated Care Systems (ICSs). ICSs have similar features and functions with the Accountable Care Organisations in the US and have been tasked to increase efficiency while improving population health and decreasing health inequalities within highly constrained resources. However, this high responsibility is a great challenge as the ICSs lack experience in prioritization of health and social care services and have limited knowledge in generating and using evidence in investment (or even disinvestment) decisions.
The seminar aims to: a) provide an overview of these policy reforms with a particular focus on the implemented provider payments, b) present the elements of Value-Based Care and their relative importance as derived from Discrete-Choice Experiments, c) describe a Prioritisation Support System for ICSs that was developed using Multi-Criteria Decision Analysis, and d) demonstrate the application of this system in the context of mental health.
Past Seminars/Webinars
Megatrends in Global Health and evolution of the Australian Health System - September 11, 2024 10am UK BST and 7pm AEST
Professor The Hon Greg Hunt
Bio: Greg Hunt is a former Australian parliamentarian who served the Australian Parliament for over 20 years, during which he held a number of ministerial positions including Minister for Health and Aged care, Minister for the Environment (when he was named best minister in the world at the World Government Summit), and Minister for Sport. While Minster for Health and Aged care he oversaw the government’s response to the COVID-19 pandemic from March 2020 until his retirement as an MP in May 2022. In that role he established telehealth as a permanent part of Medicare provision and introduced long-term policy plans for medical research, mental health and health workforce. Since late 2022 he has been the Chair of the Turner Institute for Brain and Mental Health’s Advisory Council at Monash University. He is currently an Honorary Professor at UCL Global Business School for Health and an Honorary Melbourne Enterprise Professor at the University of Melbourne.
Effects of private health insurance on hospital utilisation in a mixed public-private system - May 28, 2024
Associate Professor Jongsay Yong, The University of Melbourne
Australia has a long history of using a mix of public and private sectors for healthcare financing and provision. Like many countries, Australia is facing increasing funding pressure on health and social care due to increased longevity and ageing of the population. Whether the private sector can be relied on to relieve the funding pressure facing the public system is a key policy question that has relevance for many countries. All Australians are covered by Medicare, the publicly funded universal health insurance scheme. In addition, about 45% of Australians have private health insurance (PHI). Australian government subsidises PHI and private healthcare through a number of channels. The justification is that patients with PHI are more likely to use private rather than public hospital care, thus taking pressure off public hospitals. However, due to possible high out-of-pocket costs of private healthcare, patients with PHI may still opt to use the public system. This study investigates the degree of substitution between private and public hospital use arising from an exogenous increase in PHI enrollment. We exploit the discontinuity in the Lifetime Health Cover (LHC) policy introduced in the year 2000.
The impact of price transparency on patients’ medical costs for in-hospital services - May 16, 2024
Dr Susan Mendez, The University of Melbourne
A reason for market failure in healthcare is information asymmetry. Patients face considerable uncertainty about expected outcomes because they might be less likely to assess the complexity of their case or the type of services they require. In a setting where providers can freely set prices, patients face uncertainty in their expected fees and out-of-pocket costs. Price transparency is promoted as a key to empowering patients with information, and fostering more equitable healthcare decision-making processes.
Employer Quality, Residential Amenities and Skilled Worker Mobility: Evidence from Hospital Doctors' Location Choices - April 18, 2024
Associate Professor Giuseppe Moscelli, University of Surrey
Using administrative data on English public hospitals and a revealed-preference discrete choice framework, we study fully qualified doctors’ preferences over hospital attributes and residential amenities when changing jobs within the English National Health Service. We show that doctors joining a new hospital organization are willing to trade the cost of moving farther away from their residence in exchange for better patient care and higher rewards for clinical excellence within the hospital organization, and better school quality and lower criminality rates in the relocating neighbourhood. We also uncover significant heterogeneity patterns among different subgroups of doctors, in particular with respect to doctors’ age and gender. Moreover, we provide counterfactual simulations to assess how hospital physician vacancies would react to improvements in the organizational and neighbourhood characteristics analyzed in our structural model of physician mobility.
Country-level effects of diagnosis-related groups: evidence from Germany’s comprehensive reform of hospital payments - March 26, 2024
Professor Jonas Schreyoegg, Chair of Healthcare Management and Scientific Director of the Hamburg Centre for Health Economics, University of Hamburg
Hospitals account for about 40% of all healthcare expenditure in high-income countries and play a central role in healthcare provision. The ways in which they are paid, therefore, has major implications for the care they provide. However, our knowledge about reforms that have been made to the various payment schemes and their country-level effects is surprisingly thin. This study examined the uniquely comprehensive introduction of diagnosis-related groups (DRGs) in Germany, where DRGs function as the sole pricing, billing, and budgeting system for hospitals and almost exclusively determine hospital revenue. The introduction of DRGs, therefore, completely overhauled the previous system based on per diem rates, offering a unique opportunity for analysis. Using aggregate data from the Organisation for Economic Co-operation and Development and recent advances in econometrics, we analyzed how hospital activity and efficiency changed in response to the reform. We found that DRGs in Germany significantly increased hospital activity by around 20%. In contrast to earlier studies, we found that DRGs have not necessarily shortened the average length of stay.
Promoting engagement with a mental health smartphone app: evidence from a randomized field experiment - March 21, 2024
Dr Nathan Kettlewell, University of Technology Sydney
Using a randomized field experiment, we provide evidence on how university students respond to interventions to encourage downloading and engaging with a mental health smartphone app. Inviting students to an exclusive social media group moderated by student ambassadors has no effect on take-up, although this may be due to few students joining the group. Paying students a small amount to download and engage with the app increases downloads only modestly. Payments also increase activities completed, but across all groups engagement is low. Overall, our results suggest that university students are resistant to using a mental health app, and respond weakly to incentives. This is despite prevalent mental health issues in this group. We supplement our quantitative analysis with information from open-text survey questions and interviews to provide some insights into this reluctance.
Combining Risk Adjustment with Risk Sharing in Health Plan Systems - March 09, 2023
Health plan payment systems with community-rated premiums typically include risk adjustment, risk sharing or both to compensate insurers for predictable profits (on young and healthy people) and predictable losses (on the elderly and chronically ill). The seminar provides insight into how a payment scheme based on risk sharing alone can be improved by including elements of risk adjustment. Moreover, it shows how changes in the payment system can affect the redistribution of claims cost across different levels of coverage.
Professor Francesco Paolucci from the University of Newcastle presented on private health insurance in Australia.
Measuring outcomes and comparative value in NDIS - March 02, 2023
The National Disability Insurance Scheme (NDIS) is $29bn per year investment in the lives of people with disability, with this investment projected to reach more $59bn per year by 2030. Given the size and importance of this investment it is critical that the design of the NDIS and supporting processes and infrastructure are informed by credible evidence about what works. The National Disability Insurance Agency (NDIA) Corporate Plan recognises the importance of 'Investing in research and innovation' to support NDIS participants and the NDIS.
Dr Andy Goodall, Director Targeted Research and Strategic Evaluation National Disability Insurance Agency, provided information on the NDIA Corporate Plan and how it is supporting NDIS.
Watch Seminar
Reflections of a Chief Economist on social care policy - February 23, 2023
The Aged Care Royal Commission found too many older people are not getting the aged care they need. The quality of the care provided is often appalling with 10 to 20 percent of residents in aged care facilities experiencing some form of physical assault. More than two-thirds of residents are malnourished or at risk of being malnourished, and many residents with dementia are sedated using psychotropic agents or physically restrained. The history of aged care policy is a history of decisions about how much government is willing to spend on older people. Expenditure on aged care has not kept pace with demand since mid 1980’s. Growth in aged care places was linked to the 70+ population, whereas demand for aged care was more closely correlated to the 80+ population. Providers have also had an annual efficiency dividend imposed on them since 1996-97 through the Commonwealth Own Purpose Outlays/Expense arrangements.
Dr David Cullen, former Chief Economist of NDIS and the Australian Department of Health provided insight to the failing aged care system.
Watch Seminar
Using patient-reported outcome measures to incentivise value-based health care: a cautionary tale from England - November 20, 2022
Professor Nils Gutacker from Centre for the Health Economics at University of York, UK presented a seminar on using patient-reported outcome measures (PROMs) to incentivise value-based health care. PROMs are validated instruments that measure how patients perceive their health and health-related quality of life. Several health systems collect PROMs data to quantify improvements in patient health in routine care settings. For example, the English NHS has collected PROMs for all patients undergoing hip and knee replacement surgery since April 2009. In this talk Professor Gutacker will discuss the potential uses of PROMs data to improve equity, efficiency and value for money in the provision of health care services from an economist’s point of view.
Changes in the assessment of medicines at NICE (England) and relevance to Australia - October 20, 2022
Speakers from National Institute for Health and Care Excellence (NICE) (Ian Watson, Lorna Dunning and Zoe Garrett) discussed the changes in the assessment of medicines at NICE and the reasons for the changes, and international collaboration between health technology assessment agencies, and speakers from Australia (Bonny Parkinson and Kirsten Howard) discussed the relevance to Australia.
This is timely given NICE have recently changed some of their methods of assessment and given the forthcoming review of health technology assessment in Australia.
COVID-19: The Challenges Ahead - Achieving herd immunity - October 21, 2021
In this joint webinar in conjunction with the Health Economics Research Centre, University of Oxford, we looked beyond COVID-19 to the challenges ahead. Attendees heard from international speakers Prof Mark Jit, London School of Hygiene and Tropical Medicine, Prof Philip Clarke, University of Oxford and Susan Brown, GAVI, the Vaccine Alliance.
Prof Henry Cutler presented the findings from this landmark MUCHE study into how the financial literacy of informal carers impacts accommodation payment decisions made by Australians when entering residential aged care.
The role of Refundable Accommodation Deposits (RADs) - April 8, 2021
Prof Henry Cutler and Dr Yuanyuan Gu presented their key findings on RADs, including the size and scope of the residential aged care sector’s reliance on RADs and the relationship between RADs and provider financial performance. A recording of the presentation can be viewed by clicking on the following link.
Preferences and choice in the context of obesity - October 31, 2019
Professor Emily Lancsar, Head of the Department of Health Services Research and Policy at the Australian National University, presented an overview of a program of collaborative work designed to understand preferences, choice and behaviour in the context of obesity. This included key results from five studies. Methodological and policy insights were also highlighted.
The impact of pharmaceutical innovation on longevity and hospitalisation in Australia, 1998-2018 - October 17, 2019
Frank R. Lichtenberg is Courtney C. Brown Professor of Business at the Columbia University Graduate School of Business. Prof Lichtenberg presented the impact that pharmaceutical innovation had on premature mortality and hospital separations in Australia up until 2015, and cancer patient outcomes up until 2018, by estimating 2-way fixed effects models using longitudinal disease-level data.
The cost and quality of mental healthcare provision and the value of service quality in the English NHS - September 16, 2019
Rowena Jacobs is Professor of Health Economics in the Health Policy Team in the Centre for Health Economics at York University. Improving efficiency in mental health services in the English NHS is a key policy priority, including driving quality improvements and reducing unwarranted variations. Prof Jacobs presented her research on the efficiency, cost and quality of mental healthcare provision in the English NHS.
Valuing health using experimental auction approach - June 6, 2019
Dr Joshua Byrnes is an Associate Professor at the Centre for Applied Health Economics within the School of Medicine at Griffith University (Australia). Existing methods to estimate health state utility weights exhibit limitations in terms of complexity, validity and reliability. This seminar outlined research conducted using a novel method for eliciting the relative and absolute value of health-related quality of life based upon experimental auctions. The study results demonstrate that experimental auctions present a feasible, consistent and reliable approach to estimate the relative and absolute monetary value of health states.
Economic evaluation in health care: what is it good for? - May 6, 2019
Professor Jon Karnon, Professor of Health Economics at Flinders University, explored the notion of local economic evaluation at this presentation, discussing the feasibility and value of cost-effectiveness analyses of investment options that reflect the local context, including local processes of care, local resource constraints and local preferences.
Program evaluation and decision-analytical modelling: Estimating the cost-effectiveness of the English hip fracture pay-for-performance scheme - March 5, 2019
Cost effectiveness is rarely applied to the evaluation of health policies or system-level interventions, where the focus is often on changes in clinical processes. Nils Gutacker, Senior Research Fellow (Associate Professor) at the Centre for Health Economics, University of York, UK, presented the results of a recent cost-effectiveness evaluation of a national pay-for-performance scheme for hip fracture care in the English NHS.
Past Executive Lunches
Frank R. Lichtenberg is Courtney C. Brown Professor of Business at the Columbia University Graduate School of Business - October 17, 2019
Prof Lichtenberg presented the impact that pharmaceutical innovation had on premature mortality and hospital separations in Australia up until 2015, and cancer patient outcomes up until 2018, by estimating 2-way fixed effects models using longitudinal disease-level data.
Rowena Jacobs is Professor of Health Economics in the Health Policy Team in the Centre for Health Economics at York University - September 16, 2019
Improving efficiency in mental health services in the English NHS is a key policy priority, including driving quality improvements and reducing unwarranted variations. Prof Jacobs presented her research on the efficiency, cost and quality of mental healthcare provision in the English NHS.
Is it cost-effective to reclassify oral contraceptives and triptans? - December 6, 2018
Senior representatives from government agencies and the Australian Self Medication Industry reviewed the findings of a new MUCHE study evaluating the cost-effectiveness of reclassifying two common medications from prescription-only to pharmacy only, and the potential usefulness of an economic evaluation approach to inform medicine scheduling decisions. Following the presentation, attendees discussed how an economic approach to scheduling could be incorporated into the Australian setting.