AUSactive Supports Reform in Private Health Insurance
AUSactive is working closely with Private Healthcare Australia (PHA) to support reform in private health insurance.
The goal is to expand access to evidence-based preventive health services. These include Pilates, Yoga, Tai Chi and structured exercise programs delivered by accredited professionals.
Expanding Access to Preventive Health Services
This collaboration follows recent legislative changes. These changes now allow private health insurers to offer rebates for selected natural therapies.
Importantly, the changes come after a 2024 independent review of clinical effectiveness.
The review recommended reinstating seven therapies that were previously excluded in 2019. As a result, there is now a strong opportunity to embed preventive health into the private health system.
Building the Framework for Implementation
Private health insurers are now working with industry associations to develop key processes.
These include:
- Accreditation frameworks
- Claims processes
- Service delivery requirements
With support from professional associations, these systems are expected to be in place by early 2026.
AUSactive’s National Model for Delivery
In response, AUSactive has proposed a national delivery model.
This model focuses on:
- Accreditation
- Safety
- Clinical effectiveness
It also includes the development of new item numbers for eligible services. In addition, a structured framework will guide implementation for both practitioners and insurers.
Supporting Preventive Health Outcomes
AUSactive CEO Barrie Elvish said the reform is a significant opportunity.
“Supporting structured, evidence-based services can improve health outcomes while reducing long-term healthcare costs,” Mr Elvish said.
Key Contributions from AUSactive
AUSactive’s contribution to this reform includes:
- A national accreditation framework for exercise and active health professionals
- Industry consultation through surveys
- Practical tools such as draft item schedules, rules of use and FAQs
As a result, both insurers and practitioners will have clearer guidance.
Aligning with Industry and Regulatory Requirements
The partnership also aligns with broader industry efforts to establish claims processes.
These include:
- Defining treatment eligibility
- Developing referral pathways
- Ensuring service quality through recognised accreditation
Benefits for Private Health Insurers
AUSactive’s framework provides immediate benefits for insurers. These include:
- Increased member value
- Improved long-term health outcomes
- Reduced cost burden of chronic disease
- Modernised preventive healthcare delivery
Ongoing Collaboration
Mr Elvish said AUSactive values the ongoing collaboration with Private Healthcare Australia.
“We look forward to progressing the next steps of this important national initiative,” he said.
Learn More
👉 For more information, visit:
https://privatehealthcareaustralia.org.au/health-insurers-working-with-natural-therapists-to-develop-accreditation-and-claims-framework/
