Despite the DoHDA refusing to release its full report, IHACPA has managed to get its point across via a ‘snapshot’ of its major findings. The message is blunt.
The Department of Health, Disability and Ageing has released a consultation “snapshot” from the unreleased National Disability Insurance Scheme (NDIS) Review which says NDIS pricing arrangements “are not working”.
The snapshot, compiled by the Independent Health and Aged Care Pricing Authority, was the result of a consultation with NDIS participants, providers and stakeholders done between June and November 2024.
The government has refused to release IHACPA’s full final report on pricing, claiming public interest immunity, and maintaining that the release would “undermine cabinet deliberations”.
Participants said pricing wasn’t helping with choice of services or access, while providers said that IHACPA pricing didn’t take into account the complexity of some cases, that could impact resourcing.
Where providers were unable to hire sufficient or quality staff, this could result in “lower worker to participant ratios, and potentially unsafe environments”.
“The number one concern raised was how pricing doesn’t reflect the reality of delivering services, especially in remote areas and for people with complex disabilities,” said IHACPA.
“When some participants are waiting years for a service, there’s no room for negotiating prices, or finding better alternatives.
“We also heard how there is a big difference whether you are self-managed or not. For participants who are self-managing their plans, they report that the pricing list and supporting documents are far too complex and not particularly helpful.
“Participants, their families and carers need better information and education to navigate pricing and the empower them to have a role as a customer when purchasing supports.”
IHACPA also heard from providers that there weren’t always enough resources to go round and cover costs, or funds to invest in staff training.
“If providers are unable to hire sufficient or quality staff, this results in lower worker to participant ratios, and potentially unsafe environments,” said the snapshot.
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“This means that businesses can’t always cover the overheads that come with delivering services, let alone encourage more quality, safety or innovation. The impact of pricing on quality and safeguards is a major concern.
“The way pricing works isn’t incentivising more quality providers in the market, nor for them to take on high needs cases.”
Stakeholders in rural and remote regions had a lot to say about inequity of access and service delivery, said IHACPA.
“A one-size-fits-all model doesn’t account for the differences between states and territories, nor between metro, regional and remote areas,” said the snapshot.
“This means inequitable access and service delivery.
“Remote participants are most affected, especially in rural and remote areas where the cost of delivering services is higher. This is due to longer travel distances, fewer local resources, and difficulty accessing supplies or specialised equipment. In very remote areas, travel distances of 700 kilometres is not unheard of.
“Addressing the issues in regional and remote markets requires specialised approaches that are not possible within the current pricing arrangements.”
Stakeholders told IHACPA that there was a disconnect between stakeholders and the NDIS about why decisions were made which left them unable to make long-term plans.
“Providers feel that there is not enough information to help them plan for the changes that come through and aren’t heard in the consultation process,” said the snapshot.
“The release timing of pricing doesn’t always capture other changes like awards.
“This means that lots of providers can’t make long-term business plans and remain viable. Lots of business are reporting losses across multiple years – or leaving the scheme.
“Improvements to the way the pricing list is released provides an opportunity to rebuild relationships with participants and providers, supporting them to plan and deliver their services in a sustainable way.”
Read the snapshot here.