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Australia’s health system continues to operate under sustained pressure.
Chronic conditions affect approximately 15.4 million Australians and account for more than half of total disease expenditure. A substantial proportion of this burden is linked to potentially preventable complications, unplanned hospital admissions and emergency department presentations.
Recent national reforms, including MyMedicare, Chronic Condition Management changes, the Primary Health Care 10 Year Plan and the Strengthening Medicare agenda, rightly prioritise prevention, continuity and person-centred care.
Yet a significant opportunity remains to strengthen how these reforms are operationalised in everyday care.
While policy settings emphasise prevention and self-management, the system does not yet have a nationally consistent way of routinely understanding a person’s knowledge, skills and confidence to manage their health. Measurement does occur in some settings. However, it is often fragmented, service-specific and not embedded across programs or funding models.
Building this capability would strengthen implementation and help ensure that reform translates into measurable improvements in patient engagement and outcomes.
In day-to-day primary care, clinicians already recognise that patients vary significantly in their readiness and capacity to manage long-term conditions.
Some require intensive, structured support. Others can be supported with lighter-touch approaches.
However, this differentiation is often based on clinical judgement alone rather than a consistent, validated measure embedded within funding and commissioning frameworks.
Evidence consistently demonstrates that people with lower patient activation experience higher rates of hospitalisation, greater emergency department use and increased healthcare costs, while higher activation is associated with better self-management and more appropriate service use.
Despite this, patient capability is not routinely measured across Medicare-funded primary care.
This gap has been recognised in multiple national reviews, including the Review of General Practice Incentives and the PHN Program Final Report, which identify the need for stronger outcome measurement and better targeting within existing funding structures.
If reform is to deliver on its intent, prevention, value-based care and improved equity, the system requires a practical way to operationalise patient capability.
CFEP Surveys has lodged its 2026–27 Commonwealth Pre-Budget Submission, outlining a staged national approach to embedding the validated Patient Activation Measure® (PAM®) within existing Medicare-funded primary care models. The proposal strengthens the impact of existing government-funded services by enabling more targeted, person-centred care.
This is not a proposal to create a new program. It is a proposal to strengthen the effectiveness of services already funded by government.
The approach integrates activation measurement within:
Embedding activation enables services to:
At a system level, activation data supports more targeted commissioning and clearer assessment of whether funded services are strengthening patient capability and outcomes.
Importantly, this is operational, not theoretical.
Activation measurement is embedded within existing workflows, supported by digital integration and proportionate workforce capability development, minimising additional reporting burden.
Any proposal within the current fiscal environment must demonstrate measurable return on investment. Based on updated Australian chronic condition prevalence and expenditure data, and conservative assumptions drawn from international and Australian evidence, staged national implementation of patient activation yields significant and increasing savings over time.
The modelling indicates:
These savings accrue primarily through reductions in avoidable hospital admissions and emergency department use among low-activation cohorts, alongside more appropriate use of Medicare-funded services.
At a broader level, modelling within the submission demonstrates that even a one-point improvement in activation among low-activation patients has the potential to generate significant system savings, reflecting the disproportionate cost burden associated with this cohort.
The proposed Year 1 investment of approximately $1.6 million supports national coordination, workforce capability building, digital integration and evaluation. This represents a proportionate, high-leverage investment designed to moderate future growth in high-cost acute care expenditure.
National reform requires more than intent. It requires delivery capability.
The proposed rollout is staged over three years, beginning with pilot implementation across a representative mix of Primary Health Networks and partner organisations, expanding progressively to national coverage.
Implementation is supported by:
This approach builds on existing primary care and commissioning infrastructure rather than establishing parallel systems.
Engagement with sector partners has informed the implementation design to ensure it reflects frontline operational realities and can be adapted to different local contexts.
As the exclusive Australian licensee of the Patient Activation Measure® (PAM®), CFEP Surveys brings established measurement expertise and experience working with PHNs and service providers to embed activation-informed workflows in routine practice.
The proposal is not centred on a tool. It is centred on establishing patient activation as a nationally consistent system capability embedded within funding, commissioning and care delivery.
Australia’s reform direction is clear: prevention, person-centred care and value for money.
To deliver on this ambition, the system must move beyond activity measures and embed structured, validated ways to understand and respond to patient capability, supporting clearer measurement of value and outcomes.
Patient activation provides that missing mechanism.
By acting now, the Commonwealth can equip primary care with a practical capability that:
This proposal is designed to support discussion and refinement. Further detail, including modelling and implementation design, is outlined in the full 2026–27 Pre-Budget Submission.
CFEP Surveys welcomes continued dialogue with government and sector partners and stakeholders to shape implementation design, governance arrangements and long-term integration within Medicare-funded models.
Embedding patient activation within existing reform is not about creating something new.
It is about making current investment work harder and ensuring that reform intent translates into measurable impact for patients, providers and the health system as a whole.
Australia’s health system continues to operate under sustained pressure. Chronic conditions affect approximately 15.4 million Australians and account for more
AGPAL, CFEP Surveys and Parkinson’s Australia have partnered to deliver a national survey that will inform the development of the
