Australian healthcare funding policy needs a rethink and value-based payments will be a necessary step towards securing Australia’s healthcare system sustainability. Nevertheless, using financial incentives to change behaviour will require national leadership, substantial investment in better information technology, and improved data collection and sharing. 

The value-based payment reform journey will be long and will experience some failures, but it offers considerable opportunities to compliment the future needs and preferences of patients. Who bears the risk and who benefits must be transparent and factored into implementation to predict for uncertainties. 
It is natural for providers to push back on value-based payments if the incentive structure fails to compensate for increased risk, fails to cover the marginal cost associated with meeting incentive targets, or fails to attribute health outcomes to care. 

The likelihood of developing a program of successful value-based payment models will be substantially greater if state, territory, and federal governments develop a structured and supportive policy and institutional framework around the intent to trial and evaluate multiple value-based payment models nationally.

Four recommendations are made to establish this framework.