Australia’s health system is under strain. Demand is rising, inequities are widening and costs continue to climb. Reform cannot wait.
As physiotherapists, we know that our profession offers proven, cost-effective solutions, strengthening primary care, reducing hospital demand and improving outcome for people living with pain, chronic conditions and disability. Yet too often, patients only see a publicly funded physiotherapist once they reach hospital.
Our 2026-27 federal pre-Budget submission sets out four evidence-based reforms to strengthen Medicare, modernise funding and deliver patient-focused care. Together they show how physiotherapy can help deliver the government’s reform ambitions: unlocking access, restoring disability care, funding for equity and payment reform.
Priority 1 - Unlocking access
Priority 1 is to expand frontline capacity by integrating physiotherapy into multidisciplinary teams. The case for reform is strongest where need and cost intersect. Musculoskeletal pain, chronic conditions and disability drive demand yet remain under-addressed. Investments in non-surgical pathways, prevention and pain management offer a clear route to relieve hospital pressure while improving outcomes. Physiotherapy is positioned to lead this shift but only if funding reform embeds it where it matters most.
A reform hiding in plain sight could reshape the health system: embedding physiotherapists into multidisciplinary primary care teams. The idea is simple. Physiotherapists can shift care upstream, ease hospital demand, improve outcomes for musculoskeletal conditions and strengthen community care.
This is not about co-location. It is about commissioning physiotherapy as part of integrated care, wherever patients are seen. Supported by blended funding and aligned with GP care within multidisciplinary frameworks, these models enable earlier intervention, support team practice and generate measurable savings across the system.
Four models stand out: physiotherapy-led care for knee osteoarthritis, proven falls prevention programs, integrated pathways for low back pain and pelvic health and continence. Each demonstrates measurable savings, fewer admissions and better quality of life. Reform should begin here, connecting care through approaches that already work. Direct referral, making physiotherapy part of the Urgent Care Clinic team and digital health enablement are also firmly in this mix.
Priority 2 - Disability reform
Priority 2 is to fix the NDIS pricing failures. Physiotherapy is essential for people with disability. It enables mobility and independence and reduces reliance on hospitals and informal care. Yet the current NDIS price limit falls well below market benchmarks, triggering provider withdrawal and leaving participants with the supports they need.
Pricing errors are distorting the market and embedding systemic risks across the sector. Independent analysis by the Nous Group shows that the NDIA’s 2025-26 price cap of the $183.99 an hour is misaligned with actual rates of $215 to $259. The methodology underpinning the limit is deeply flawed, built on inappropriate data and unrealistic assumptions; it fundamentally fails to account for the complexity of disability supports.
Priority 3 - Funding for equity
Priority 3 is to deliver care where it matters most. Healthcare reform is driven by important intentions, but delivery has not yet reached the areas of greatest need. For example, prevention, reablement, paediatrics and women’s health continue to sit at the margins. This leaves rising demand unmet, opportunities for early intervention missed and communities without the services that would make the greatest difference.
Funding for equity means redesigning the system so that investment follows need, physiotherapy is embedded in primary care and reform reaches the people it was meant to serve. Another example is aged care reform, which is overdue but incomplete. The Aged Care and Other Legislation Amendment Bill 2025 was a welcome start yet far more is needed to meet the complex healthcare needs of older people in the community.
These failures reflect misplaced policy priorities that block access, fragment prevention and leave reablement, paediatrics and women’s health underserved. Paediatric early intervention lacks investment, the potential of physiotherapy in women’s health is still not fully realised and preventative care continues to be reactive rather than proactive.
The APA’s pre-Budget priorities have been shaped by the need to ensure that reform is not only promised but delivered.
Priority 4 - Payment reform
Priority 4 is geared towards market stability. Broken payment models trigger market withdrawal and erode access, leaving communities without care. Fractured payment systems threaten provider viability and disrupt care continuity. Harmonisation is often presented as a fix but risks compounding access issues by importing flawed assumptions across programs. Uniform pricing models are collapsing thin markets in rural and remote areas, Department of Veterans’ Affairs pricing sits below viability thresholds and aged care commissioning is driving provider exit.
Reform must strengthen systems, not weaken them. Payment reform is about sustaining providers so communities can rely on care. Funding must align with workforce sustainability, service quality, clinical complexity and the realities of rural and remote delivery. A national agenda must anchor pricing in evidence-based disciplines, recognise cost variation, support flexible commissioning and embed independent oversight.
Rising demand, widening inequities and escalating costs show why reform must move from intention to delivery. Physiotherapy is ready to provide the solutions the system needs in strengthening primary care, reducing hospital demand, restoring disability care, driving equity and stabilising payment models.
Our 2026-27 federal pre-Budget submission sets out a clear, evidence-based agenda to embed physiotherapy where it matters most, ensuring that communities across aged care, disability, prevention, women’s health and rural Australia can rely on sustainable, patient-focused care.