The Latest NDIS Price Guide: Understanding the Impact on Therapy Businesses

Last week, the National Disability Insurance Scheme (NDIS) released an update to its price guide, outlining the pricing arrangements and limits for therapy supports. As a business owner in the therapy industry, I have carefully examined the key points of this update and their implications for our sector.

In this article, I aim to shed light on the concerns faced by therapy businesses and the challenges posed by the NDIS price guide,  but perhaps even more importantly to highlight the role OTs are playing in the NDIS. 

 Occupational Therapy and recognising our value and role in the scheme: 

Occupational therapy plays a pivotal and indispensable role within the framework of the National Disability Insurance Scheme (NDIS). As dedicated occupational therapists, our primary focus is on capacity building and promoting independence for our clients. We strive to empower individuals to do more for themselves, aiming to reduce their reliance on the scheme over time. Our ultimate goal is to equip our clients with the skills and strategies necessary to lead their definition of a fulfilling life.

On a daily basis, we work tirelessly to advocate for the sustainability of the NDIS. We understand the importance of responsible resource allocation and ensuring that funding is directed towards supports that truly make a difference in the lives of our clients. We are conscious of the limited resources available and the need to balance the provision of quality services with the financial sustainability of the scheme.

 As occupational therapists, we are constantly faced with the challenging task of navigating the complex landscape of the NDIS. We find ourselves in the unfortunate position of having to adhere to its rules and guidelines, while also working closely with our clients to determine when requests are reasonable and necessary. This involves carefully assessing each individual's unique circumstances and aligning their goals with the intended outcomes of the scheme. We are always focussed on ensuring that funding is allocated to supports that will have a meaningful and lasting impact on our clients' lives.

In knowing all of this, it is incredibly disheartening to witness the government and media often portraying our profession as one that "price gouges" the NDIS. While we acknowledge that there may be outliers in any field, the vast majority of occupational therapists are hardworking professionals who are deeply committed to their clients' well-being (and to scheme sustainability).

 It is important to recognise the inherent value that occupational therapy brings to the NDIS. We possess unique expertise in facilitating functional independence, enhancing participation in daily activities, and promoting overall well-being. Our interventions not only benefit individuals but also contribute to long-term cost savings within the scheme by reducing the need for ongoing support.

 In a system where financial pressures and increasing demand pose ongoing challenges, it is crucial to acknowledge and appreciate the essential role occupational therapists play. We will continue to advocate for recognition and fair compensation for our services, as we believe that a thriving and sustainable NDIS is contingent upon the expertise and dedication of all allied health professionals, including occupational therapists.

Which brings me to my evaluation of the price guide and it's lack of increase for therapists. 

 No Adjustments to Pricing Arrangements: 

According to the NDIA, after extensive market analysis and consultation, there will be no adjustment to the pricing arrangements and price limits for therapy supports on 1 July 2023. While the NDIA justifies this decision by stating that the current price limit of $193.99 is above the average fully loaded hourly cost of most therapy professionals, the reality on the ground may differ significantly.

Real Impact of Price Limits: 

It is important to recognise that whilst the price figure for therapy services has not been literally reduced in the price guide, the lack of adjustment that fails to account for the changing economic landscape means that in reality is has. 

Since the last increase (in 2019), statutory superannuation has risen by 1.5%, and the Consumer Price Index (CPI) has increased by approximately 17.7% from 2019 to 2023. In real terms, this translates to a reduction of approximately 19.2% in the hourly rate, that puts the true rate at $156.59. 

 Even if the impact of CPI was more conservatively applied, this hasn't yet factored in the surge in demand for occupational therapists and the resulting inflated wage environment that the NDIS largely created. 

 This rate is well below any other insurance scheme we operate in and whilst 19.2% on top of the existing rate ($231.24) is well above other insurance schemes, the disparity surely means at the very least, the 5.75% other workers in the price guide were afforded was warranted for us too. 

 Impact of NDIS Demand on Occupational Therapists: 

The NDIS has undeniably created a surge in demand for occupational therapists. While this increased demand is a positive outcome for participants seeking therapy services, it has also contributed to an environment of scarcity. The limited supply of occupational therapists has led to increased competition for their services, ultimately driving up wages. However, the current pricing arrangements fail to reflect this new reality, leaving therapy businesses struggling to cover the costs associated with hiring and retaining qualified therapists.

Considerations for the Future: 

While the NDIS argues that therapy price limits remain competitive compared to other government schemes and private billing rates (something I would contest is accurate in WA) it is crucial to assess the impact on the ground. The growing demand for therapy supports, coupled with the need for a diverse range of therapists to meet participant needs, necessitates a revaluation of the pricing arrangements.

Looking Ahead: 

As the NDIS Review examines non-price-related solutions, it is imperative for the NDIA to consider structural changes to therapy pricing arrangements in light of the current challenges faced by therapy businesses. Taking into account the surge in demand, the scarcity of therapists, the economic environment the whole country is operating in (we aren't exempt from it) and the inflated wage environment, adjustments to the price limits are necessary to ensure the sustainability of therapy businesses and the provision of quality outcomes for NDIS participants.