Pricing Review Implementation Update

The NDIA have just announced the nine recommendations from the Independent Pricing Review that they will be prioritising for implementation with the Price Guide update in July 2018. These recommendations are listed below, with references to their page numbers in the Independent Pricing Review for those seeking further information:

4 – Regional Travel (p.44): The NDIA should clearly define rural areas and lift travel allowance from 20 minutes to 45 minutes for providers serving a participant located in MM5 (or ARIA equivalent) and MM4 in the short term. Adjust participant plans to account for travel and track travel as a separate line item. 

10 – Short Term Accommodation (p.57): The NDIA should continue to refine the assumptions for high intensity rates, active overnight, and capital allowances used to develop the new STA price schedule, to ensure they reflect the cost of service delivery.

14 – Temporary Support for Overheads (p.72): The NDIA should implement ‘temporary support for overheads’ (TSO) in the form of a temporary increase to the price cap for standard intensity attendant care. Government should offer business planning support for large providers that would otherwise exit and create the risk of supply shortages.

15 – Cancellation policy for core supports (p.75): The cancellation policy for attendant care should be amended so that up to a certain threshold, providers can charge against a participant’s plan for up to 90% of the entire duration of the scheduled service if the participant makes a short notice cancellation. Above this threshold, providers will need to demonstrate they are actively working with participants to minimise the risk of cancellations in order to continue charging for cancellations.

16 – Group supports (p.78): The NDIA should implement a new pricing schedule for group care (both community based and centre based) outlined in Table 4 that allows providers to recover additional costs incurred for groups, while still retaining the incentives and efficiencies of group based care. It should also assess whether a capital allowance should be provided for centre based care based on whether there is demand to increase the number of centres.

18 – Therapy assistants (phase one) (p.82): The NDIA should amend the description for therapy assistants and introduce two tiers of prices for therapy assistants – one that is comparable to the attendant care price, and a second that is for the delivery of therapy supports by a professional with a lower level of skill than a qualified therapist.

19 – Therapy travel (p.84): The NDIA should align the travel policy for therapy supports to the travel policy for attendant care by removing the $1000 travel cap, allowing providers to charge up to 20 minutes at the hourly rate when travelling between participants.

20 – Cancellation policy for therapy (p.85): The cancellation policy for therapy should be amended so that up to a certain threshold, providers can charge against a participant’s plan for up to 90% of the scheduled service if the participant makes a short notice cancellation. A cancellation line item should be created as a governance mechanism for the NDIA.

21 – Reports requested by NDIA (p.86): The NDIA should allow providers to charge participants for the time spent writing reports that are requested by the NDIA. A new line item should be introduced for tracking purposes.

Implementation of recommendations relating to market monitoring and engagement (Recommendations 1, 11, 12, 13, 22, 23 and 24) has already or will commence by 1 July 2018. The timeline the NDIS has committed to for recommendations 2, 3, 5, 8 and 25 is suitably vague: "the short to medium term".

The Agency has also identified five recommendations that require further consultation prior to implementation. These recommendations include:

  • 6 – Defining complexity (p.50)
  •  7 – Price tier that accounts for complexity of supports (p.51)
  • 9 – High intensity loading for centre based activities (p.55)
  • 17 – Therapy price limits (p.80)
  • 18 – Therapy assistants (phase two) (p.82)

DC will continue to update you as more detail on how these recommendations will be implemented becomes available.