2016-17 Fellowship Areas of Interest

The aim of the Fellowship is to enrich policy thinking. Many topics of interest, development and the issues around health reform which are current in the US are equally relevant in Australia. Applicants are invited to propose topics of interest to them that they believe will advance the policy agendas of the two countries.  Studies which compare policy development, evaluate strategies, or compare aspects of health care practice are welcomed.

Some suggested broad topic areas are provided here.

  • Implementation of reform

What are the particular challenges of reform in a federal system? How are they being addressed? How have they been overcome? How do the structures for policy coordination in Australia such as COAG compare to equivalent structures in the US, and how does this show up in the differing experiences of the reform process?

  • Performance reporting

How has performance reporting been implemented in the two countries? What are the levels of awareness in different target audiences for these reports?  How useful have the performance measures been for policy development? How do the (performance) reports address disadvantaged groups (such as indigenous, low socioeconomic groups)?

  • Activity Based Funding

What are the challenges in developing a national payment model? How have incentives changed and what has been the impact? What factors explain variation in health care costs across populations? 

  • Safety and quality 

What strategies have been used in Australia to improve safety and quality? How do these compare with US strategies? Have they been successful?

  • Coordination of care

What strategies have been used to improve coordination of care? What have been successful? What lessons are there from the development of Medical Homes in the US for Australia? How do experiences in managing comorbidities in the primary care context vary between Australia and the US? What are the problems and barriers to improved coordination of primary care and long-term care?  Are there innovative programs that have successfully integrated primary care and support services? Is mental health care well-coordinated with primary care?

  • Patients with complex chronic conditions

How are high-risk patients with chronic conditions identified and managed? To what extent are they cared for by multidisciplinary teams? What kinds of programs support patient self-management? Do physicians receive incentives for managing patients with complex chronic conditions? Are there any mechanisms for integrating health and social services?

  • Use of IT 

How has the Personally Controlled Electronic Health Record been implemented? What is its acceptability? What IT based strategies have been successful in improving quality of care? To what extent can providers at different sites of care share patient information electronically? 

  • Patient centered care 

What strategies have been successful in developing more patient centered care? How has consumer feedback been used in improving quality of care? In what ways is IT enabling patient engagement?

  • Health care workforce 

How effective are existing policy tools, financial incentives, and organizational arrangements for promoting the most efficient use of the health workforce or sectors of it? What flexibility is there for substitution across professional groups? How does this differ between Australia and the US? What approaches could be adopted to align the distribution of medical practitioners more closely with patterns of need, especially in rural and remote communities?

  • High Cost/High Need Populations:

What  approaches have been successfully employed to identify and design programs for high cost/high need population groups and vulnerable populations.  Are there system approaches which integrate clinical, behavioral, social support and long term support services?

  • Innovations

How to identify breakthrough opportunities, i.e. disruptive innovations that will positively impact the health care system, such as the use of health information technologies to change the way patients are engaged and care is delivered, and how to foster successful development from concept to scale.

  • Health care financing

What are the challenges in developing a national payment model? How have incentives changed and what has been the impact? What factors explain variation in health care costs across populations? Are pay for performance strategies likely to be effective in Australia? What other incentives should be considered?

  • Transparency

How transparent are the cost of pharmaceuticals and medical services to the consumer, compared to the US?  Does it make a difference to consumers? What strategies are available to address the rising costs of pharmaceuticals?

  • Costs and quality

How have funding strategies affected attempts to improve quality and reduce costs? What has been the impact of recent changes to allow patients of professionals other than doctors to access Medicare benefits? What are the longer term implications for the quality and cost of health services of such steps towards workforce “substitution”? What is the impact of out-of-pocket costs on the use and quality of health care?

  • Prevention

What strategies have been successful in encouraging preventive care in primary care? In hospitals? In aged care? How have health care systems coordinated with community based services to improve preventive care? What is distinctive about Australia’s approach to health promotion? How have programs addressed the needs of special groups?

  • Indigenous/Minority Health:

How effective are mainstream versus targeted services at addressing indigenous/minority health needs? How can differential approaches for under-serviced population groups, including addressing patients’ social service and basic resource needs, contribute to these populations’ access to and quality of health care services? How effective are existing policy tools, financial incentives, and organizational arrangements for promoting the development of health professionals from indigenous and non-English speaking backgrounds?

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