Outcomes and value-based care

SIRA engaged the University of Melbourne to analyse high-impact care items and develop algorithms that can be used to identify and monitor these services using routine claims data.

This research examines patterns of care across the NSW workers compensation and NSW Compulsory Third Party (CTP) schemes to identify opportunities to strengthen value-based care. The project focuses on tests and treatments that may provide limited clinical benefit, may expose people with an injury to unnecessary risk, and may increase costs without improving outcomes.

Healthcare costs across SIRA-regulated schemes exceed $1 billion annually, with rising expenditure not consistently translating into improved recovery and return to work outcomes. Strengthening value-based care supports better outcomes for people with an injury, improves the quality and appropriateness of treatment, and contributes to policy affordability and scheme sustainability.

Understanding where variation occurs allows SIRA to target improvement activities, promote value-based care and reduce unnecessary costs and risks for scheme users and the broader community.

This project will deliver:

• Algorithms and statistical code for up to five high-priority care services, enabling ongoing monitoring across the NSW workers compensation and CTP schemes.
• Evidence on the prevalence, cost and potential risks associated with these services, including hospital admissions and hospital-acquired conditions.
• Data outputs to support targeted regulatory and quality improvement activities.
• Recommendations to strengthen data capture, reporting and use, and support interventions that promote high-value, appropriate care.

These outcomes will support SIRA’s work to improve outcomes for people with an injury, maintain policy affordability and strengthen scheme sustainability.

Partners:

• University of Melbourne
  Professor Adam Elshaug, an international expert in low-value care and health system performance.

Project completed: September 2025

The REFORM trial evaluated whether remotely delivered physiotherapy was as effective as standard face-to-face physiotherapy for people with musculoskeletal (MSK) conditions.

SIRA partnered with the John Walsh Centre for Rehabilitation Research (JWCRR) to support the trial and translation of findings. The study compared a supported home exercise program delivered via digital tools and remote follow-up with a standard six-week face-to-face physiotherapy program.

MSK conditions were common in work-related injuries and motor vehicle crashes. Standard care often required multiple face-to-face sessions, which could be difficult for people with an injury to attend due to location, mobility, or work and caring responsibilities.

This research supported SIRA’s focus on telehealth and value-based care by assessing whether a remotely delivered model could achieve comparable outcomes while improving accessibility and maintaining quality and satisfaction.

Key findings:

• People with certain MSK conditions achieved outcomes comparable to those receiving face-to-face physiotherapy.
• There was no difference in satisfaction or perceived improvement between groups, indicating strong acceptance of the remote model.

Implementation considerations included:

• Patient and clinician beliefs about hands-on therapy
• Assessing suitability on a case-by-case basis
• Co-design with practitioners to support adoption

These findings contributed to the evidence base for telehealth in the NSW workers compensation and CTP schemes and informed future service delivery approaches.

Partners:

• John Walsh Centre for Rehabilitation Research (JWCRR)
  Lead researcher: Professor Lisa Harvey.

The trial was conducted across five Sydney public hospitals. Multiple awards received for the research in 2025.

Project completed: December 2023