Hive's Health Team Attends the 2026 Health Insurance Summit

The Summit brought together representatives from private health insurers, private hospitals, government, industry bodies and other healthcare stakeholders to discuss key developments shaping Australia's private health insurance sector.

The event provided a valuable opportunity to engage with industry leaders and explore a range of current and emerging reforms aimed at strengthening the sustainability and accessibility of Australia's private health system.

PHI Reform

On the second day of the Summit, Joanna Green, Principal, moderated a panel discussion on private health insurance reform featuring:

• Dr Katherine Bassett, Acting CEO, Catholic Health Australia
• Nick Bailey, Senior Executive, Healthcare Funding and Policy, Medibank
• Ravinder Carothers, General Manager, Health Funding, Strategy and Performance, St John of God Health Care

The panel explored a number of significant reform proposals, including the potential introduction of a national private efficient price, changes to private maternity and mental health services, the private health insurance rebate for older Australians, product simplification and phoenixing, risk equalisation and the proposed establishment of a minimum private health insurance benefit for Hospital in the Home (HITH) services.

Balancing Innovation and Sustainability

In particular, the HITH reforms are intended to provide greater funding certainty and incentive for private hospitals to provide lower-cost care outside traditional hospital settings. HITH services can support a wide range of patients, including those requiring treatments such as intravenous infusions, complex wound management and palliative care, often allowing care to be provided in the comfort of a patient's home.

As with any significant reform, the discussions highlighted the importance of careful policy design. One of the key considerations raised was ensuring that HITH programs genuinely substitute existing hospital-based care, rather than becoming an additional service layered on top of existing treatment pathways. If not implemented appropriately, there is a risk that HITH could increase overall healthcare expenditure rather than deliver efficiencies.

The panel also considered operational challenges, including those faced by private hospitals. From a patient perspective, affordability and certainty around out-of-pocket costs remain important considerations.

Importantly, the panel noted that many of these concerns may be addressed through contractual arrangements between insurers and providers, including agreements that provide benefits above any regulatory minimums and greater cost certainty for patients.

Looking Ahead

The Summit reinforced that meaningful reform in the private health insurance sector will require ongoing collaboration between insurers, healthcare providers, policymakers and industry stakeholders.

As these initiatives continue to evolve, balancing innovation, affordability and sustainability will be critical to ensuring reforms deliver improved outcomes for patients while supporting a strong and effective private health system.

Our team looks forward to continuing to work with stakeholders across the health sector as these important reforms develop.

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