Three takeaways from the industry’s biggest event

Over the past two days, I had the opportunity to attend the Health Insurance Summit alongside leaders from health funds, providers, government and technology partners.

As with any conference, there were plenty of interesting announcements, statistics and policy discussions. But what stood out to me wasn’t what was different between speakers. It was how aligned they were.

Whether the speaker represented a health fund, a hospital, government or an industry partner, they were largely describing the same future for private health insurance. Prevention. Better navigation. Connected care. Greater collaboration. More personalised support. There was remarkably little disagreement about where the industry is heading.

The real question isn’t what the future looks like anymore. It’s how we get there.

Here are my three biggest takeaways 👇🏻

1. Prevention has become the industry’s answer to sustainability

If there was one message that echoed throughout almost every session, it was that Australia’s healthcare system simply can’t continue operating as it does today.

The conversations started in different places. Some focused on affordability. Others on chronic disease, mental health, hospital viability or the challenges of an ageing population. Yet they almost always arrived at the same conclusion, we have to become better at keeping people well, rather than waiting until they become patients.

Several statistics reinforced the urgency. Only around 2% of healthcare spending is currently invested in prevention, despite global benchmarks sitting above 5%. Another speaker highlighted projections that healthcare costs per person could triple over the next 40 years if current trends continue.

Mental health was another recurring theme. Rather than being discussed as a standalone issue, it was consistently positioned as a major contributor to healthcare demand, workforce productivity and long term system sustainability. Chronic Disease Management Programs, community health hubs and insurer-funded mental health pathways were all presented as practical examples of investing earlier to improve outcomes later.

What struck me most was that nobody challenged the premise. Five years ago, prevention often felt like an ambitious idea. At this summit, it felt like accepted fact. The debate has shifted from whether prevention matters to where health funds should invest, how success should be measured and how proven initiatives can be scaled.

2. Health funds want to become partners, not just payers

The second theme was the changing role of private health insurers.

Historically, the industry’s value proposition has largely centred on funding hospital episodes. Increasingly, however, the conversation is shifting towards helping members stay healthy, navigate the system and access the right care before they need hospital treatment. While the major insurers have been seeking this ambition for a number of years, it’s starting to permeate through the entire industry.

There were numerous examples of this throughout the summit. Connected care platforms. Hospital in the Home. Community health hubs. Chronic disease pathways. Digital navigation services. Population health initiatives. While each organisation is approaching it differently, they all point towards the same ambition, becoming a genuine health partner rather than simply an organisation that pays claims.

Kate Williams from Bupa captured the challenge well when she described today’s health system as being “like finding a new suburb on an old map.” The healthcare system has evolved, consumer expectations have evolved, but many of the structures and funding models haven’t kept pace.

That evolution also depends on stronger relationships across the sector.

Ravinder Carothers from St John of God Healthcare perhaps summed it up best when he said, “We need a feed, not a fight.” It was a simple line, but one that resonated. Whether discussing prevention, Hospital in the Home, transparency or mental health, there was broad recognition that insurers, providers and government can’t solve these challenges by working in isolation.

There was also an important reminder that consumers continue to trust clinicians more than insurers. If health funds want members to see them as genuine partners in health, earning that trust will be just as important as developing new products or services.

Further listening/viewing

These conversations reminded me of our recent Innovation Insider podcast episode with Chris Zinn, who did a fantastic job as MC across the two days. Chris has spent decades advocating for Australian consumers, and our discussion explores trust, value, consumer expectations and where private health insurance needs to evolve. It’s also proof to backup my comment during the summit that Chris has an affinity for short-sleeve party shirts!

3. The strategy isn’t the problem anymore

The final theme, and perhaps the one I found most interesting, was that the industry doesn’t appear to be short of ideas. Speaker after speaker described a remarkably similar destination. Better navigation. Prevention. Connected care. Greater transparency. More personalised experiences. Improved health outcomes. The vision is increasingly shared.

Execution is where the challenge begins.

Rhod McKenzie from nib captured this perfectly when he said, “The year of investing in pilots is gone.” It was one of the standout quotes of the two days because it reflects where the industry finds itself today. Health funds don’t need more proof that prevention works or that new care models have potential. They need the confidence, capability and organisational capacity to scale those ideas.

“The year of investing in pilots is gone.” Rhod McKenzie from nib

That observation resonated strongly with me because it also shaped the presentation Natira Drayton from Civica and I delivered during the summit titled Why some health funds move faster than other: The hidden leadership skill behind successful transformation.

We spent our session talking about where private health insurance is heading in the context of a different question. If we already know where we’re going, why does progress still feel so hard?

Working with insurers and countless organisations over our 40 years of combined experience, we have both consistently observed that leaders aren’t short of ambition. They understand the future. They have strategies. They have investment. Yet progress often feels slower than anyone would like because organisations are simultaneously navigating legacy technology, competing priorities, governance, limited capacity and the challenge of bringing people with them.

We introduced what Natira calls the Organisational Movement Model, built around four simple but challenging questions

1. Do people genuinely believe the current state is no longer good enough?
2. Do they understand where the organisation is heading?
3. Do they trust the leaders asking them to move?
4. And can they see the role they’ll play in creating that future?

The conversations after the session suggested those questions resonated just as strongly as the discussions around healthcare reform.

Final thoughts

The most encouraging takeaway from the summit wasn’t a new policy announcement or a piece of technology. It was the level of alignment across the industry.

There is broad agreement that demographic change, chronic disease, affordability pressures and rising consumer expectations require a different approach. And there is growing recognition that prevention, better navigation and stronger collaboration will all play an important role in the future of private health insurance.

Now comes the difficult part.

As PHA CEO Rachel David warned during one panel discussion, “We’re on an upward death spiral,” referring to the long term sustainability of Gold products. It was a confronting reminder that maintaining the status quo isn’t a viable strategy.

The organisations that succeed over the next decade won’t necessarily be those with the boldest vision. Most leaders already have a clear view of where healthcare is heading.

The difference will be their ability to build trust, make difficult decisions and consistently turn strategy into meaningful action. That’s ultimately what will determine who shapes the future of private health insurance, and who spends the next decade talking about it.

If your executive team is wrestling with these same questions, let’s have a conversation.