As an NDIS Provider, it's important you know that the NDIS has released a report titled "The Role of Pricing and Payment Approaches in Improving Participant Outcomes and Scheme Sustainability".

It's a monster 54 pages and addresses the fact that NDIS markets are not operating as efficiently as the NDIS had hoped 10 years into the scheme.

The NDIS does not feel Participants are receiving the best outcomes and Providers are being paid efficiently.

The report has 4 key findings and asks all NDIS Providers like yourselves to share your opinion on them.

We have summarised the key findings below as well as providing a link where you can provide your feedback in a very simple form.

Here are the key findings:

1) There are opportunities to improve NDIS pricing arrangements over the short- to medium-term

Price caps (as per the NDIS Support Catalogue) are not supporting the development of a responsive and innovative market. Providers have little incentive to compete on price or quality, with price caps acting more as a ‘price anchor’ than a‘price ceiling’.

Most price caps are set based on an estimate of the ‘cost of service provision’ for the lowest-cost providers, but more detailed information on the ‘true’ cost of service delivery is needed.

Some providers have also suggested that they are unable to invest in the capability of their workforce under current pricing arrangements because workers can leave and join independent support worker online platforms.

Implementing ‘preferred provider’ panel arrangements – where providers agree to supply supports at an agreed price and on agreed terms – may be a possible alternative to price cap arrangements for certain NDIS supports.

2) For most NDIS supports, Providers are paid for each hour of service they deliver, regardless of the ‘value’ for Participants.

Providers have a financial incentive to provide more services and/or increase staff ratios regardless of the benefit to Participants.

The NDIS is considering using these alternative Provider payment approaches that focus more on Participant value:

1. Enrolments - E.g. Participants are signed up for a specific period of time. This can  strengthen the focus on a Provider’s relationship with Participants and encourage them to invest in participants’ capabilities. It could  also stabilise demand which helps with maintaining your workforce.

2. Outcomes - E.g Providers are paid in full for helping Participants reach their goals/outcomes. Participants may  choose Providers on the basis of the Provider’s past outcomes or performance.

3. Blended - E.g. A mix of payment options. A combination of Enrolments and Outcomes which may put greater focus on Participant outcomes without relying wholly on a pure outcome payment.

How can different payment approaches be used across different services like Daily Living and Therapies?

3) A lack of transparency around prices, volume,quality and outcomes is restricting the effectiveness of NDIS service delivery

Participants can find it difficult to compare Providers or negotiate prices as they cannot readily access the information they need to make informed decisions. The NDIA has limited visibility of whether the supports Participants purchase help to achieve outcomes.

There is no requirement for Providers to publish a price list for the full set of services they offer – the only exception is Providers claiming TTP for certain supports.

Measuring and reporting on Provider performance – that is, the extent to which they provide quality supports that achieve outcomes for Participants - should be available to Participants in an accessible format.

4) Removing price caps could place pressure on scheme costs. Instead, the focus should be on foundational market reforms that help align incentives for Participants, Providers and governments

Foundational market reforms are needed to align incentives for Participants, Providers and governments to ensure Participants have the information, support and capability to make informed choices on the value and quality of supports.

Providers need to be incentivised to compete on price and quality, and deliver the volume and mix of supports that improve outcomes for Participants.

What are your thoughts? Let the NDIS know before July 31 2023!

• How can the NDIS better align Provider payments with Participant outcomes?

• Should there be price caps? What’s the alternative?

• How can your suggested approaches to payments and outcomes be built into the NDIS? (no good telling the NDIS what to do without telling them how to do it)

Have your Say as an NDIS Provider before 31 July

Provide your thoughts on any or all of the above findings.
Have your say.
Let the NDIS know how the marketplace is working for you.