Examples of our work: Evaluation and Review

Evaluation of the COAG Section 19(2) Exemptions Initiative – Improving Access to Primary Care in Rural and Remote Areas

In 2006–2007 the Council of Australian Governments (COAG) introduced the Section 19(2) Exemptions Initiative – Improving Access to Primary Care in Rural and Remote Areas Initiative (the Section 19(2) Initiative), which enabled non-admitted and non-referred professional services at specified locations to be claimed under Medicare when also funded through a State or Territory.

The Australian Government Department of Health (the Department) engaged HMA to

‘undertake a robust review of the COAG Section 19(2) Exemptions Initiative – Improving Access to Primary Care in Rural and Remote Areas – to determine how the Initiative achieves its objectives’

Evaluation of the Section 19(2) Initiative will address the following evaluation questions:

  • What effects has the Section 19(2) Initiative had on approved eligible sites?
  • Have Section 19(2) Initiative improved access to primary health care services?
  • Are current Section 19(2) Initiative eligibility criteria appropriate to achieve the Initiative’s objectives?
  • Are current administrative arrangements and processes appropriate for management, accountability and transparency purposes?
  • Does the Section 19(2) Initiative continue to meet the need to improve access to primary health care in rural and remote areas?

The review will be undertaken in the following eight project stages:

Stage 1: Project planning

Stage 2: Situation analysis

Stage 3: Evaluation plan

Stage 4: Data collection ‒ HMA will collect a range of qualitative and quantitative data via surveys and interviews conducted with relevant stakeholders to gather feedback on the effectiveness of the Section 19(2) Initiative from a range of stakeholder perspectives.

Stage 5: Case studies ‒ HMA will investigate the impact of the Section 19(2) Initiative on different communities by conducting a series of ten case studies at selected sites to gain an in-depth understanding of how well sites are able to meet the objectives of the Initiative and identify barriers to future success of the Initiative.

Stage 6: Data analysis

Stage 7: Information synthesis

Stage 8: Preparation of the final report

The project commenced in December 2020 and is due to be completed in October 2021.

Review of the Radiation Oncology Health Program Grant Scheme– Australian Government Department of Health

The Radiation Oncology Health Program Grant (ROHPG) provides a contribution to the capital funding of high-cost radiotherapy equipment (i.e. linear accelerators) to ensure equitable access to radiotherapy services across Australia. Given the changing context of radiotherapy in Australia, the Australian Government Department of Health engaged HMA to assess the effectiveness of the ROHPG Scheme against the objectives of the program, including the impact of revised arrangements introduced in 2017. Key tasks included:

  • preparation of a review framework and consultation strategy, including development of a program logic and key review areas for analysis
  • desktop review of relevant literature, program documentation, policy and data to provide background context for the program and the broader radiotherapy sector in Australia
  • stakeholder consultation of public and private radiotherapy facilities that receive ROHPG funding, the Department, jurisdictional departments of health (or equivalent), peak bodies and colleges, safety and quality agencies, consumer advocacy groups, and linear accelerator vendors
  • analysis of ROHPG program data, AIHW radiotherapy data and MBS radiotherapy data to examine radiotherapy usage trends over time by jurisdiction and geographic remoteness (Modified Monash Model), trends in MBS ‘bulk-billing’ rates by geographic remoteness and estimated demand for radiotherapy services based on optimal utilisation rates and cancer incidence projections
  • trade-off analysis of the existing ROHPG funding arrangements compared with six alternative funding mechanisms to assess the pros and cons of each with regard to the status quo
  • review of ROHPG application guidelines and assessment process for ongoing relevance and accountability, and
  • preparation of a draft and final report that detailed the review findings and provided recommendations for the ROHPG program going forward.

The project commenced in August 2020 and was completed in December 2020.

Preliminary Evaluation of the Community Nursing Program (including assessment of fee schedule) – Department of Veterans’ Affairs

The Department of Veterans’ Affairs (DVA) purchases a wide range of health services for entitled persons (eligible veterans and/or their spouse) through its Community Nursing Program (CNP). The program aims to keep entitled persons living independently in the community and reduce early admission to hospital.

In response to health policy changes and the introduction of new state and federally funded community programs, DVA engaged HMA to conduct a preliminary evaluation of the CNP. The preliminary evaluation included assessment of the needs of clients accessing the service, how well the needs are met, how the CNP contributes to desired client outcomes, and a desktop review of current fee structure compared to market value. Key tasks included:

  • consultation with a range of stakeholders including program administrators and providers
  • thematic analysis of stakeholder feedback
  • quantitative data analysis to determine program effectiveness
  • desktop analysis of the CNP fee schedule
  • facilitation of a stakeholder workshop to present project findings and test preliminary recommendations
  • development of recommendations for a more comprehensive program review.

This project was completed in February 2019.