Samantha Donovan: As the federal government tries to rein in spending on the National Disability Insurance Scheme, its managing agency has cut the prices NDIS participants can be charged for certain therapies. The NDIA says the reductions are necessary because many therapists are charging more than the market rate. Service providers, though, say the new price caps will drive high-quality care providers out of the sector. Luke Radford has more.
Luke Radford: Every year, the NDIA, which is the agency that runs the National Disability Insurance Scheme, reviews the prices therapists can charge participants. Essentially, it sets a cap on how much the NDIS is willing to pay for a service. This year, the agency has lowered many of those price limits, arguing they’ve blown out and now cost much more than similar services covered by private health insurance or Medicare. The new caps, coming into effect on the 1st of July, cut between $5 and $10 off the prices for many services. Lower prices might sound good, but many in the industry argue the consequences could be severe.
Michael Perusco: Our view is that there is enough money in the scheme. It is about getting the best value for money.
Luke Radford: That’s Michael Perusco, CEO of National Disability Services, the industry body representing organisations that deliver services under the NDIS. Michael Perusco says while those providers will now be forced to charge less, their costs will keep going up.
Michael Perusco: I think it will lead to increased pressure on quality providers and lead to further exits of quality providers, which will undermine the sustainability of the scheme. Is that already happening? So there is a large Victorian organisation that announced this week they are leaving the market and they have a thousand clients on the scheme and the financial pressures that the scheme pricing has put on them has led to that exit. And the decrease in therapy prices that were announced yesterday are really going to make it very difficult for quality providers to remain in the market.
Luke Radford: Alongside these price changes, the NDIA also released a report by its independent pricing committee. The committee argues one of the key issues is that the current approach is one size fits all. Essentially everyone can charge up to the same price, no matter how complicated the case is. It suggests adding a higher price limit for complex or specialist cases, something Michael Perusco agrees with.
Michael Perusco: There are people on the scheme who have very complex support needs and that requires a specialist response from an experienced, from a quality provider. And the cost of providing that support is very different to the cost of taking someone shopping or some sort of other activity like that, which while worthwhile, just has a different cost structure.
Luke Radford: Michael Perusco isn’t alone. Other bodies like Speech Pathology Australia say the one size fits all approach is compromising care, as does Dietitians Australia. Its president, Dr Fiona Willer.
Fiona Willer: Let’s take somebody who has established disability with a swallowing issue and so that person will need a speech pathologist to ensure that their swallow level is assessed properly and a dietician to make sure that what they’re eating meets their nutritional requirements and they don’t slip into malnutrition, which is a very, very quick way to get people into the hospital system and a hugely more expensive way to deliver care.
Luke Radford: Dr Willer says that’s also why the price cuts don’t make sense, because any potential savings will still come back to taxpayers and potentially be more expensive.
Fiona Willer: Somebody who needs care is going to have to receive it from NDIS or through the Medicare systems or through the hospitals. So this is another case of hot potato, hot potato.
Luke Radford: It’s not all cuts. Under the changes, frontline disability workers will actually receive a pay rise of just under 4%.
Samantha Donovan: Luke Radford reporting.
