NDIS Review update - Share your thoughts

NDIS Review recently released a significant discussion paper on the role of pricing and payment approaches in improving participant outcomes and scheme sustainability. Click here to read more about the paper and to access a copy. 

The paper outlines the potential future for NDIS pricing and payments. They are not proposing to remove price caps, but are looking at some other proposals to improve service quality and ensure outcomes are achieved for participants. We know from members that issues with inadequate pricing are a key factor affecting the viability of OT practices and OTA will be preparing a submission that advocates strongly for pricing improvements that ensure OTs receive adequate remuneration, and can support training, supervision, and service innovation so that OTs can continue to operate sustainably in the scheme, and provide high quality services for NDIS participants.  

We want to hear from you on your thoughts on the following questions. Please submit comments to policy@otaus.com.au by Friday 7 July.

Pricing Questions

• Do you support more transparency in NDIS price setting, like an independent body? Currently the NDIA sets prices caps, and we think independent decision making (with the right mix of skills and direction from government) might be a good idea to separate pricing decisions from the NDIA budget.
• The NDIS Review is proposing to update current price caps so they reflect the differences in the costs required to deliver services to certain participants, e.g those with complex needs and in regional areas. We know some OTs and practices are struggling to provide complex clinical care under the current price caps. Would you support differentiated pricing based on client complexity and location?  
• NDIS review is proposing to introduce preferred ‘provider arrangements’ – i.e. a group of providers who negotiate with NDIA to provide specific services at negotiated/set rates. We have concerns if this is introduced at a large scale, that this may impact smaller OT practices, and might also impact participant choice and control. What do you think?

Outcomes payments:

NDIS is considering trialling funding that is linked to outcomes measures to encourage quality, rather than current fee-for-service which links payment to volume of services. For example they are looking at options including:

• Payments for providing supports over a period of time, or an ‘enrolment payment’. These could be good for predictable support needs, e.g., core supports
• Payment when a participant achieves an outcome, called an ‘outcome payment’. We think there would need to be careful planning to determine appropriate outcomes, but might look like a participant entering employment, independent living, etc.
• Payments using a mix or ‘blend’ of different types of payments, called a ‘blended payment’.

We want to hear from members on their preferred approach to receiving payment for services. Are any of the above options attractive, do they present any risks to your practice provision, or would you prefer to continue to be paid via fee for service?

Better public information on pricing and quality

NDIS is also proposing to improve access to information about NDIS providers so participants have access to information about provider quality and pricing.

• How do you feel about NDIA collecting more information on NDIS transactions to inform their data and market planning? Broadly we think there needs to be more and better data collected by NDIA and think this is a good idea as long as it doesn’t increase red tape for providers. Do you have any concerns about this?
• They are also considering requiring providers to openly share their prices, potentially through an online marketplace. Do you have any concerns about this? We note some OTs already do this. We especially want to hear from providers servicing self-managed participants on how this might affect you.
• The review is proposing to also measure and share information on provider performance (possibly like the Aged Care star rating system). Do you have any concerns about this?

Market reform

The review is not proposing to remove price caps at the moment; however, they are looking at broader market reforms that help align incentives for participants, providers and governments, such as:

• Giving participants better information and support to make decisions about their providers and supports, including on the role of ‘support coordinators’ and ‘plan managers’.
• Changing market rules to encourage providers to deliver the services that would most benefit participants and governments.
• Helping participants to find and buy supports in certain sub-markets (like certain services, cohorts of participants or different communities).
• Better articulating the role of different governments across the NDIS market (including Councils).

Do you have any concerns with these proposals?

Do you have any other feedback on pricing issues or preferred solutions that would help you operate sustainably?

Please note you can also have your say direct to the NDIS Review by clicking here. Submissions close on 31 July.