A Shift from Activity to Outcomes: Reforming Commissioning in Western Queensland

A Shift from Activity to Outcomes: Reforming Commissioning in Western Queensland

Western Queensland Primary Health Network (WQPHN) is transitioning from activity-based commissioning to outcomes-based commissioning, grounded in the principles of Value-Based Health Care (VBHC).

For too long, commissioning in rural and remote health has focused on funding activity rather than outcomes, counting occasions of service instead of measuring meaningful change for individuals, paying for inputs rather than investing in what communities truly value, and operating within short 12-month funding cycles when trust, workforce, and sustainable service delivery take years to establish.

WQPHN is actively moving away from this model.

Through its Outcomes for the Outback (OFtO) framework, now being implemented via the Healthy Outback Communities (HOC) program, WQPHN is embedding a new approach built on three key commitments, recently tested directly with providers:

• Stability of resources, enabling providers to recruit, plan, and retain workforce in thin markets, where the loss of a single clinician can significantly impact an entire community.
• Shared accountability, with outcomes defined by what matters most to local communities rather than by program guidelines developed in metropolitan centres.
• Local engagement and trust-building over time, ensuring services deliver meaningful results that reflect the maturity, integration, and unique needs of communities across western Queensland.

The urgency for this shift is clear. The 64,111 people who call western Queensland home, including 13,015 Aboriginal and Torres Strait Islander people cannot continue waiting for systems designed elsewhere to meet their needs. Communities deserve investment models that reflect the realities of delivering care across vast and remote regions, and VBHC only becomes meaningful when funding genuinely follows outcomes.

WQPHN acknowledges and thanks every stakeholder who has contributed to this journey. Their honesty, insight, and collaboration have been critical in shaping a more effective and community-led commissioning model.

As outcomes-based commissioning and VBHC continue to evolve in rural and remote health, WQPHN welcomes ongoing conversation and shared learning. This is not a final destination, but a long-term direction with much still to be learned and achieved.