Published on 6 Oct 2025

Review of Medicare Benefits Schedule Continuous Review function

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Allen + Clarke developed an Evaluation Framework for the Department of Health, Disability and Ageing’s Medicare Benefits Schedule (MBS) Continuous Review function during a period of high operational demands. Through document reviews, interactive workshops, and stakeholder interviews, we created a living framework with a Program Logic, Data Matrix, and practical analytical approach. The Framework supports the Department to monitor Review activities consistently and efficiently, delivering a streamlined evaluation process that adapts to the evolving needs of this critical healthcare function.

Key Takeaways:

  • Developed a flexible "living document" Evaluation Framework that evolves with the MBS Continuous Review function, supporting long-term relevance and utility.

  • Created practical monitoring triggers and consistent evaluation processes that accommodate the Department's high operational tempo. 

  • Engaged senior officials and key stakeholders through tailored workshops to ensure the Framework addressed real-world implementation needs.
By engaging directly with key stakeholders throughout the development process, we ensured the framework reflected real-world operational constraints while maintaining evaluation best practices. The Department now has a practical, sustainable approach to monitor their Continuous Review function in a timely, consistent and manageable way.

Medicare Benefits Scheme

The Department of Health, Disability and Ageing oversees the Medicare Benefits Scheme, Australia's cornerstone healthcare funding system, and its Continuous Review function. With the Department facing significant operational demands, they required an Evaluation Framework that could integrate seamlessly with their existing workflow while ensuring robust assessment of this critical new function.

The MBS Continuous Review function was in its early stages, presenting the challenge of creating an Evaluation Framework flexible enough to evolve with an emerging program. Department staff had limited availability due to high workloads, requiring our team to adapt our engagement approach to match their operational tempo. The Framework needed to deliver consistent, manageable evaluation processes for a complex healthcare funding system that impacts millions of Australians.

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Our Approach

Allen + Clarke's expertise in healthcare policy evaluation and program logic development positioned us well to address these challenges. Our experience with Evaluation Frameworks for evolving programs enabled us to create a solution that balanced immediate practical utility with long-term strategic value.

Our approach combined methodological rigour with practical implementation considerations:

  • Document analysis - we reviewed key program materials to understand the MBS Continuous Review's objectives, processes and contextual factors. 

  • Interactive virtual workshops - we facilitated engaging sessions with Department staff to co-develop the Framework's core elements and ensure operational feasibility. 

  • Stakeholder interviews - we conducted targeted discussions with senior officials to incorporate strategic perspectives and ensure alignment with broader organisational goals. 

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The Evaluation Framework

The resulting Evaluation Framework integrated several innovative features designed specifically for this context. We developed a comprehensive Program Logic that articulated the relationship between review activities and intended outcomes, providing a clear roadmap for evaluation. The accompanying Data Matrix identified practical, accessible measures that minimised additional reporting burden on the Department.

Recognising the evolving nature of the MBS Continuous Review function, we designed the Framework as a living document with clear guidance on when and how to update it. This included specific triggers for monitoring and evaluation activities, ensuring the Framework would remain relevant as the program matured.

Our work delivered operational benefits for the Department:

  • Streamlined monitoring - the framework established consistent processes for tracking review activities without creating additional administrative burden. 

  • Practical implementation pathway - clear guidance documentation enabled immediate application despite the Department's limited capacity. 

  • Adaptive evaluation approach - the living document design ensured the framework would evolve alongside the MBS Continuous Review function, providing sustained value. 

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