How Value-Based Healthcare Can Transform Injury Insurers in Australia

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Injury insurance in Australia — from workers’ compensation to compulsory third-party (CTP) schemes — has too often rewarded the volume of services delivered rather than the quality of recovery. The result? Endless appointments, scans, and treatments without a clear focus on whether injured persons actually recover and return to work.

At eHealthier, we’ve reflected on Cognizant Technology Solutions’ perspective and explored how Value-Based Healthcare (VBHC), supported by digital tools, can disrupt and improve this model. We believe VBHC principles, applied in the injury insurance space, can reshape how insurers collaborate with providers, injured persons, and health systems.

The Current Challenge

• Activity-driven payments - Services reimbursed, outcomes overlooked
• Fragmented data - Recovery details scattered across systems and providers
• Misaligned incentives - Longer treatment pathways sometimes rewarded over faster, effective recovery

This creates inefficiencies for insurers, frustrations for providers, and slower, less effective recovery for injured Australians.

Where VBHC + Digital Tools Make the Difference

• Predictive analytics - Spot early which injured persons need extra support, preventing complications and costs
• Outcome dashboards - Track improvements in pain, function, and quality of life instead of tallying treatments
• Risk stratification - Match injured persons to the right level of care, avoiding over- or under-treatment
• Real-time reporting - Build transparency for insurers and providers, aligning everyone around recovery

Why It Matters for Injury Insurers

When insurers move toward VBHC, they stop paying for activity and start paying for results. This means:

• Faster, more sustainable recovery for injured persons
• Lower claim costs and improved efficiency for insurers
• Stronger collaboration across the system
• A model that rewards quality outcomes, not volume of services

The Way Forward

Injury insurers that embrace VBHC and digital disruption can improve both financial outcomes and the wellbeing of injured Australians. This isn’t just a reform in healthcare delivery — it’s a roadmap for smarter, fairer, and more effective insurance systems.

As Xrays allowed us to measure or assess organs that were invisible to see, IT/Clinimetrics enables us to see and measure these invisible parameters that reflect life and health.

For further context, see Cognizant Technology Solutions’ article: Seven Megatrends Shaping the Future of Australian Injury Management.