Providers pay a heavy price for NDIS bureaucracy

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There are plenty of news stories on people with disability being left out of pocket, anxious and even hospitalised due to the stress of dealing with the National Disability Insurance Scheme.

But the people with a disability are not the only ones suffering -  the service-providers endure a bureaucratic nightmare just to get paid, too.

There are currently around 12,600 registered providers in Australia. All must navigate the fearsome NDIS Price Guide every time they invoice for any service.

This Guide – a bean counter’s dream – is a 280-page compendium of hundreds of price tables, yielding over 2,500 line items.

It’s up to the provider to identify the correct price and support item reference number; else the NDIS refuses to pay them.

The complexity can result in a mistake which can potentially hit the viability of their business. And consequently some people don’t get the care they need.

Each price table relates to an exact set of variables: the category of service being rendered, the profession and designated NDIS registration group of the provider rendering it, and the State or Territory where they rendered it.

And if the service happens to be supplied beyond our main population hubs, the provider must accurately decide whether the area is ‘Remote’ or ‘Very Remote’.

How? NDIS suggests bush-based providers check something called the Modified Monash Model. It’s a handy but very-hard-to-find online tool that classifies nearly 16,000 Australian locations on a one-to-five scale of geographic isolation.

NDIS unhelpfully provides no link. I eventually found it on the Australian Department of Health portal for GPs.

But once the right table has been found, the real fun begins. The hapless provider then needs to identify the line item.

For this, there are three specified Support Purposes and eight Outcome Domains, which in turn relate to a sub-set of 15 support categories.

Once the codes for the support category, support item, registration group, domain group, unit of measure and funding type have been found, there’s an added layer of complexity over whether the service was quotable.

It’s a hell of a lot of administration, just to get paid for a service they’ve already provided in good faith.

We also have to consider, what will this level of NDIS-induced stress and aggravation do to the mental health and wellbeing of our care-providers?

We are proud to say that Holocentric includes a fully searchable and up-to-date version of the NDIS Price Guide as part of its free Centro online package for providers.

We hope this tool – along with many of the others available in Centro – takes away the angst currently afflicting what is otherwise a highly valuable and compassionate government scheme.

Huge Growth of NDIS Service Providers Predicted

 Source: NDIA list of providers analysed by  Centro  from Holocentric Pty Ltd.

Source: NDIA list of providers analysed by Centro from Holocentric Pty Ltd.

According to the National Disability Insurance Agency there is expected to be huge growth in the number of NDIS service providers and only the most effective and efficient will be viable. Today there are over 100,000 people with Disabilities on the NDIS and predictions are for over 400,000.  There are currently 11,000+ service providers now and the expectation is that there will be a quadrupling of the number of providers, employing some 70,000 staff.  Using the same growth factor, massive change is coming.

Currently, Service Providers can register for up to 36 different registration groups. The top 10 registration groups that service providers are currently registered for in Australia is shown in image above.

In our analysis we found that:

  • Largest providers are nominated in over 30 registration groups
  • 30% of providers are registered in just one group
  • Most in demand Registration group is Therapeutic Supports which accounts for 30% of providers.

To keep up to date with the latest changes as the NDIS continues to evolve, join Centro.

Quality Management in the Disability Services Environment

Centro-Insight

In the Quality and Safeguarding Framework it states that you will need to focus on processes and put plans in place to monitor, review and communicate the quality of your services, supports and products.

Once the National Quality and Safeguarding Framework is enacted, there are 3 core obligations on a service provider in order to be compliant

  1. Worker Screening - Educate existing personnel and onboard new employees so that services can be delivered consistently
  2. Complaints Processes - Feedback systems, dispute management processes and acting on that feedback.
  3. Incident Reporting - According to the NDIS Quality and Safeguarding Framework, 9 December 2016, “Providers have primary responsibility for preventing and managing serious incidents, so they are expected to have processes for this as part of their risk management system.”

Not complying has serious consequences. Complying can create administrative overheads and strain the efficiency of an organisation.  Bringing Quality Management standards and processes into your organisation will save time and energy.

For more information, visit our post on the Holocentric Blog

Pricing for a Viable Disability Services Sector

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With the release of the McKinsey ‘Independent Pricing Review’ recommendations recently there is now need for even more clarity over pricing and claims.  McKinsey & Company stated in their Report that the "recommendations will have a positive impact on provider economics, improving overall industry margins by 2% to 4%, with even higher margin improvements for providers serving participants with complex needs or in rural, remote and very remote areas". 

In summary:

  • Price changes are coming and are estimated to cost the scheme between $250m and $420m per annum over the next 12-24 months.
  • Adding a third tier to the complexity loading of 10%, to account for higher level of skills/experience of workers and additional training required
  • Changing the therapy prices to better reflect different therapy types, and introducing a second tier of pricing for therapy assistants
  • ·A model of Transitional Support for Overheads (TSO) in the form of a 2-3% increase in the price cap of 1:1 attendant care for the next 12 months

Of course, this will add further complexity to the pricing scheme. NDIA has indicated that these changes should be implemented within the next 6 months, most likely on 1 July 2018. Centro will remain a source of information, and will be continually updated as the inevitable changes are implemented. 

Centro at NDS QLD Conference 2018

On 5 - 6 March, we attended the NDS QLD Conference to showcase Centro FREE to disability service providers. Pricing is one of the main issues impacting service providers and there was a lot of buzz at the conference with McKinsey & Company announcing the 'Indepdent Pricing Review' just before. 

We're eagerly awaiting the official changes to occur from the NDIA so we can update Centro for the hundreds of people that have already signed up.