Bupa calls for prevention-led health reform in new policy paper

20 August, 2026

A new Bupa reform paper is advocating that prevention should be at the centre of Australia's next phase of health reform as Australia's health system is struggling to keep pace with chronic disease.

 

Bupa’s discussion paper, Building a More Accessible, Modern and Sustainable Health System, sets out a vision for a health system better equipped to address the chronic disease burden affecting 15.4 million Australians, with Australians spending almost 11 years of their lives in ill health, much of it linked to preventable or manageable conditions.

 

Developed in part with economics, strategy and policy consulting firm, Mandala Partners, and launched today at Parliament House in Canberra, the paper focuses on ways to expand access to preventive and primary care, accelerate adoption of innovative models of care, improve access and affordability in specialist services, and strengthen the long-term sustainability and viability of Australia's health system.

 

Bupa APAC CEO Nick Stone said: “We have one of the best health systems in the world, but it was designed for a different Australia and a different era of care. The next generation of healthcare will require bold, practical reform.

 

“Prevention should be at the centre of Australia's next phase of health reform,” Mr Stone said.

 

“An ageing population, rising chronic disease, workforce shortages, growing out-of-pocket costs and increasing financial pressure on governments and households are already affecting how Australians access care. Customer expectations have also changed dramatically.

 

“Too often, the system is organised around health episodes, institutions and locations rather than the journeys, continuity of care and outcomes that people face.

 

“Our ambition is simple: to help Australians live longer, healthier and happier lives. To achieve that, healthcare must become more connected, preventative, convenient and centred around patients. That’s why we want to work with government and key sector leaders to ensure Australia’s health system remains sustainable, accessible and fit for the future.”

 

Key recommendations in the report include:

• Establish a National Prevention Partnership Framework to help governments, providers and insurers invest in prevention, improve health outcomes and reduce pressure on hospitals.
• Enable private health insurers to fund prevention and early intervention including health checks, screening, coaching and care coordination before conditions become serious.
• Give insurers greater flexibility to fund mental health care outside hospitals, potentially avoiding 41,000 admissions and saving $140 million a year.
• Expand Hospital in the Home so more Australians can receive hospital-level treatment including IV antibiotics, wound care and post-operative recovery safely at home.
• Continue moving Medicare towards blended funding that rewards prevention, chronic disease management and coordinated care involving nurses, pharmacists and allied health professionals.
• Fast-track workforce reforms, including streamlined pathways for overseas-trained doctors, a national specialist workforce plan and expanded specialist training.

 

The paper reinforces healthcare workforce shortages are becoming one of the biggest threats to access and affordability, with Australia facing a projected shortfall of more than 8,600 GPs and 12,800 specialists by 2048, while four in ten GPs are already aged 55 and above.

 

Bupa is calling for urgent reforms focusing on prevention, early intervention and chronic disease management, as current funding and regulations remain largely focused on treating illness after it becomes more serious.

 

The paper notes Australia recorded almost 788,000 preventable hospitalisations at a cost of $7.7 billion in 2023-24, highlighting the growing cost of treating illness after it develops.

 

“Preventive health represents one of the greatest opportunities to improve health outcomes, reduce long-term costs and ensure the sustainability of the health system. Improving health outcomes through better management of chronic disease and reduced hospitalisations is key and reorienting our healthcare system towards prevention… is a large part of the solution to tackling chronic disease,” the paper states.

 

Evidence in the paper shows prevention initiatives generate a median return of $14.30 for every dollar invested, making prevention one of the most effective investments available to the health system.

 

The discussion paper highlights current funding has not kept pace with contemporary healthcare needs, with lower returns for longer consultations, where patient needs are complex or chronic conditions are involved and favouring consultations and interventions after illness develops rather than preventive care and ongoing management.

 

“While Medicare's fee-for-service design funds individual episodes of care, it is poorly suited to prevention and coordination. As demand for health services continues to increase, investment alone will not be enough. We must look at preventative health models to help slow this rise,” the paper says.

 

“GPs frequently need specialist input on a discrete question, but the MBS provides no dedicated mechanism for brief specialist advice outside a formal consultation, and case-conferencing items are ill-suited to routine secondary consultation.”

 

More than 300,000 mental health-related presentations to public emergency departments in 2024-25 highlight the need for earlier intervention, with the paper calling for greater flexibility to fund evidence-based mental health care in community and digital settings before people reach crisis point.

 

“Mental health is one of the most substantial and persistent pressures on Australia's health system, workforce and economy. Rebalancing towards prevention and out-of-hospital care would improve system efficiency and increase the return on existing investment,” the report says.

 

Mr Stone said achieving meaningful and lasting change will require shared responsibility and genuine collaboration between governments, clinicians, insurers, providers, consumers and the broader health sector.

 

“We welcome the important steps the Government has already taken to lay the foundations for reform in several of these key areas. Our recommendations are intended to complement those efforts and support a health system that is more connected, prevention-focused and centred on the needs of patients,” he said.

 

To read the full Building a More Accessible, Modern and Sustainable Health System discussion paper click here

 

For more information, please contact:

Aleks Devic                                                    
Bupa Head of External Communications                                    
Email: [email protected]     

Mob: 0412 868 933                                                                     

 

About Bupa Asia Pacific

Bupa is an international healthcare group which has been committed to a purpose of helping people live longer, healthier, happier lives and making a better world for more than 75 years. Bupa Asia Pacific operates in Australia, New Zealand and Hong Kong, supporting about 8.2 million customers through a broad range of health and care services including health insurance, aged care, dental, medical, optical and hearing services.  Employing more than 22,000 people in the region, we believe that we can make a real difference to the lives of customers through our values, purpose and the way that we deliver personalised care. Over the past 20 years we have invested more than AUD$40 million in partnerships and programs focused on improving health of communities across Australia.