Both the public and private health system is essential to the health and wellbeing of Australians. While our world-class system has many strengths, it’s under a lot of pressure. Healthcare is costing more and is becoming increasingly unsustainable.

Medibank is working across the healthcare sector to ensure our 3.7 million members and the wider community continue to access world-class healthcare.

Australia’s health landscape is changing

The health sector faces increased pressure as lifestyle and other factors change:

  • We’re living longer, which means our healthcare needs are changing.
  • New health technologies are expensive and constantly emerging.
  • Chronic health conditions are becoming more common.
  • A lack of integrated services has meant management of these conditions is increasingly complex.

This pressure on Australia’s healthcare system is eased by the $19 billion that health insurers pay out in benefits for customers' healthcare each year. For this to continue, private health insurance premiums must stay affordable. A healthy private system equals a healthy public system.

Australia's private health


of Australians have private health insurance


billion is the amount health insurers pay out in benefits each year

2 in 5

Hospital admissions are funded by private health insurers

A healthy private system equals healthy public system

APRA Operations of Private Health Insurers Annual Report 2015-2016, Australian Institute of Health and Welfare 2016. Admitted patient care 2014–15: Australian hospital statistics. Health services series no. 68. Cat. no. HSE 172. Canberra: AIHW.

A closer look at costs

Private health insurers in Australia pay out more in benefits every year. This has led to premiums increasing by around 6 per cent per year over the past decade to keep pace with these rising costs.

Members are being admitted to hospital more often, and accessing more services each time they’re admitted. The costs of those services are also increasing.


Increases over the last five years


Increase in hospital admissions per member


Increase in benefits paid per member

* Refers to five-year growth in Medibank (excluding ahm) hospital claims from June 2011 to June 2016

What we’re doing

Working towards a sustainable and affordable healthcare system demands change. Real change means working with doctors, hospitals, policy makers, and the broader community. This will help create a more transparent, affordable and quality private health system.

This means putting our customers first and advocating on their behalf. We’re guided by our Triple Aim of Healthcare, focusing on three essential areas:

  1. Improving the health outcomes of patients. This means focusing on preventative health, better primary and community care programs.
  2. Improving efficiencies and reducing waste. The right care has to be delivered to the right patient at the right place at the right price.
  3. Improving healthcare experiences. Treatment must be patient-centred and responsive to their needs and preferences. This means driving change in areas that are most important to them.


Medibank’s Triple Aim of Healthcare

Improve health outcomes

Improve efficiencies and reduce waste

Improve healthcare experiences

*Based on The Institute of Healthcare Improvement's Triple Aim of Healthcare

How we’re doing it



Advocating for reform

On behalf of our customers, we’re advocating for reform. We recently made a number of recommendations to the Australian Government to increase quality, transparency and affordability of private healthcare. These include:

Making the price of prostheses fairer

Currently, customers in the private sector can pay up to seven times more than the public sector for prosthetics, such as artificial hip and knee replacements. The difference is even higher when compared to similar health systems overseas. To combat this, we’ve recommended to government that prostheses pricing be set against domestic and international benchmarks, to give our customers a better deal and return an estimated $800 million to Australian consumers. 

Increasing transparency for informed consumer choices

We want to empower consumers to make informed healthcare choices. This allows them to more actively participate in their healthcare, and provides insurers and providers the information they need to better target consumers’ healthcare needs. This means better health outcomes for patients and a more efficient health system. 


Investing in primary care

One in five Australians now live with two or more chronic conditions. We know that the prevention and better management of chronic conditions gives people a better quality of life and helps them stay out of hospital. This is why we’re investing in primary care with CareComplete. 


* COPD data refers to prevalence (captured as self-reported emphysema and/or bronchitis in Australians aged 55 and over) published in ABS 2012. Australian Health Survey: First Results, 2011–12. ABS cat. no. 4364.0.55.001 Canberra: ABS.

Source: ABS 2016. Australian Health Survey: First Results, 2014–15. ABS cat. no. 4364.0.55.001 Canberra: ABS.

Medibank’s CareComplete programs focus on improving the outcomes and quality of life for Australians living with chronic conditions. Through the initial pilots and rollout of the programs we have enrolled more than 10,000 patients and already worked with more than 1,800 GP clinics and 3,600 GPs to deliver CareComplete.

Partnering with hospital and ancillary providers


Medibank supports its customers through over 500,000 surgeries and more than 1.3 million hospital admissions each year, and we want them to receive quality and affordable healthcare no matter which hospital they attend.


Customer surgerieseach year


Customer hospital admissions each year

Beyond funding healthcare, we want to see our customers receive quality and affordable healthcare no matter which hospital they attend.

We are working with our private hospital partners to ensure our contracts encourage quality, safety and improved efficiencies in the interests of our customers and their patients, and we recognise hospitals who deliver higher standards of care.

Quality of care, from a good healthcare experience through to the best long-term health outcome, is a goal shared by Medibank and the broader healthcare sector.

Medibank is working with hospitals and doctors to understand variances in the way care is provided. For example, we are partnering with the Royal Australasian College of Surgeons (RACS) to improve surgeons’ access to information on indicators such as complication rates, length of patient stay and prices charged for their services. This partnership is helping clinicians to consider any improvements that could enhance clinical outcomes and patient care.  

We also measure our customers’ satisfaction with their hospital experience and treatment. This research can help deliver better practices and better experiences.


Our approach has seen one hospital work with a surgeon to schedule hernia operations in the morning so patients can be discharged the same day. Such a simple change has seen patients not having to stay in hospital overnight – which is good for them as they get to go home sooner, reduces costs by avoiding overnight stays and makes a bed available for another patient.

By encouraging and rewarding higher standards of care, we’re putting affordable and quality healthcare for customers above everything.

Ancillary providers

We work with ancillary providers to enhance the quality and experience for patients, while keeping the cost affordable. Our contracts with 12,800 providers across specialist services are all part of our Members’ Choice program.

Supporting healthy lifestyles

At Medibank, we stand for better health. We want our customers to enjoy happy and active lifestyles, with fewer health issues. Through a number of supportive programs, we’re helping build a commitment to a lifetime of health and wellbeing.

Our focus on Growing Healthy Kids is about investing in local programs to encourage healthy and active lifestyles in childhood. For example, we’re partnering with the Stephanie Alexander Kitchen Garden Foundation, a school-based healthy living program that educates children about the importance of healthy eating.

We are investing in local programs to encourage healthy and active lifestyles in childhood.

Investing in health and medical research is another way we’re supporting better health for Australians. Through the Medibank Better Health Foundation, we aim to promote healthy behaviours, inform policy and support better health outcomes.

Medibank supports projects and health-based initiatives in Aboriginal and Torres Strait Islander communities, working to close the health gap and achieve equality in health and wellbeing for all Australians. Medibank is proud to have been the first private insurer to launch a Reconciliation Action Plan (RAP) in Australia.

Medibank supports a range of projects and health-based initiatives in Aboriginal and Torres Strait Islander communities.

Our partnerships and programs such as the Australian Open, Melbourne Marathon and parkrun Australia as well as initiatives such as GymBetter are supporting Australians to achieve healthier lifestyles. We also partner with Sydney Gay and Lesbian Mardi Gras to support a culture of diversity, respect and inclusion.


A better tomorrow

So far the results from our initiatives have shown Medibank can partner with others in ways that dramatically improve our members’ health, their care experience, and the affordability of their treatment. But we have only just started. We will keep working hard to be a part of a better health system and a better health advocate for every Australian.

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