Accounting, valuing and investing in health care: dealing with outdated accounting models

Purpose Despite major progress made in improving the health and well-being of millions people, more efforts are needed for investment 21st century care. However, public hospital waiting lists continue to grow. At same time, there has been increased e-health digital interventions enhance population reduce admissions. The purpose this study is highlight accounting challenges associated with measuring, investing value setting. authors argue that requires nuanced performance metrics effect a shift from technical practice one embraces social moral values. Design/methodology/approach This research based on field interviews held clinicians, accountants administrators hospitals throughout Australia Europe. multidisciplinary narratives offer insights issues relating valuing managing decisions post-COVID-19 “value-based health-care” future Findings find complex activity-based funding models operate as black box, limited clinician understanding hybridised expertise informed social, ethical decision-making. While malleability economics-derived models, contestation conflict evident operationalisation these practice. Activity-based (ABF) mechanisms reward patient throughput volumes but at time stymie health. Although classified strategic investments, limit planning. Research limitations/implications Accounting become increasingly visible contested during pandemic-driven health-care crisis. Further required examine hybridising it implicated incremental changes ABF emergence value-based care strategies. operationalising economic practice, currently being blamed dysfunctional decisions. education practicing operational change. includes significant dilemmas result mix choices service provision. Originality/value involved team accounting, health, information systems, clinical expertise. Unique move provided. contributes policy development literature accounting.