Thank you Resilient Ethical Providers.
Allied Health Providers, you’ve worked hard this year following the rules, serving clients, billing fairly, am I right?
It seems that elements of the government, associated agencies and the media still don’t grasp the bottom line reality of both the wider allied health and the nuanced NDIS markets. In response to the NDIS Quality and Safeguards Commission’s cruelly timed and wonderfully flawed publications released this week regarding differential pricing, I offer up three scenarios of my own.
A person visits a physiotherapy clinic with a mild injury after tweaking a muscle in the gym. After the client completes a short history form in the waiting room, the physio completes a brief assessment, spends some time completing some manual therapy and then talking through the rehab plan. She records case notes as she goes. The whole session takes about 40 minutes. The client leaves the clinic room, taps her card at the desk for $150 and leaves. With the clinical case now closed, the physio moves on to her next client.
A person with a NDIS plan makes an appointment with the physio. In this instance the person has voluntarily disclosed that they have a NDIS plan which is managed by a Plan Manger. The Allied Health Business Owners admin team, of which she has had to increase by 1 FTE to manage the admin load of the NDIS, readily send out a multimedia service agreement, a welcome pack and consent form.
The customer service superstar calls and emails the client several times to answer questions and support them to complete the paperwork prior to the appointment. The admin team also contacts the relevant Plan Manager to ensure that funds are available as the clinic is already carrying several thousand dollars of NDIS debt due to failed or missed payments, recovery of which accounts for .3 FTE of the admin team. All these comms are documented and time and care is taken to share updates across the admin team.
Prior to the appointment the participant has provided a few reports and letters, the admin team have collated and uploaded these documents and alerted the physio, who then dedicates the reading time required to ensure a personalised, efficient and quality service is provided from the first session. In addition to reading documents provided, the physio may have already spent a few hours reading up on this particular diagnosis and has reached out to some colleagues to ensure that she has as much information as possible.
The Participant arrives and has a permanent and impactful disability, as is the criteria for eligibility to the NDIS.
The now fully prepared physio then spends most of the first session time completing an assessment utilizing a range of tools and techniques. Towards the end of the initial session the Participant hands over an additional large quantity of reports covering recent years of intervention. Such important paperwork provides the treating physio with additional reading and due to the clinical complexity, she seeks supervision or peer mentoring to confirm the best possible path for intervention.
The participant fortunately has a sizeable team supporting them, contemporary best practice indicates that communication with the wider team is critical and the participant requested and approved this indirect service. This prompts an ongoing email conversation between the Participant, the physio and the broader team regarding goals and approaches that will work for her life.
The physio starts a collaborative, person- centred therapy plan that will be modified over time. The physio logs and documents all face to face and non-face to face time in the Practice Management System (a recently upgraded system designed to support allied health business owners trade within the NDIS operational challenges), issues relevant emails and admin is alerted.
The admin team raise an invoice and send to the Plan Manager and hopefully a few days later the account is paid with no pay on the day in this instance. Finally it is time for issuing receipts to the Plan Manager and the Participant and checking that team wide comms are filed correctly and are easily accessible in the case of an NDIS audit or complaint.
A client visits the physio clinic. She has a mild acquired permanent disability after falling from her bike. She is ineligible for most compensation/ insurance schemes and is waiting for the outcome of her application for the NDIS. Her GP has provided a Chronic Disease Management Plan which provides about $53 per session for 5 sessions with the physio. She has been unable to work since the accident and is surviving with government income support. She is unable to pay a gap for the session.
Once again her physio prepares thoroughly and provides a great initial session within the time to rebate limitations this scenario provides. The remaining four sessions will need to be carefully managed to tide this client over what may be months, the physio is wracking her brain for alternative support services to ensure optimal rehab opportunities and functional outcomes for this struggling new client.
This Allied Health Business runs the risk of losing considerable money and professional satisfaction on scenarios two and three. The later being a not-so-secret concern as allied health professionals continue to leave the sector for less complex and more satisfying work elsewhere.
Please, change the narrative
The majority will agree that the NDIS has funded remarkable positive change and opportunity for thousands of people with disability, to achieve this allied health professional has probably served millions of paid or donated hours this year alone helping people for all the right reasons. For sure there are a handful of fraudulent providers, please do your job and deal with them. Now is not the time and place to insinuate that the whole allied health provider scenes are price gouging rogues.
Making statements about price differentials with LIMITED oversight about the cost and circumstance of conducting allied health business is unfair. Making statements about price differentials with seemingly no mention of relevant information such as location, duration, treating tools and facilities etc… is unhelpful. Lobbing such potentially misinformed information into the media, at the end of a year loaded with the ABC Four Corner episode, many and varied media articles, the Royal Commission Report and the NDIS Review is not how Allied Health Business Owners want to celebrate their years hard and life changing work with their teams.
We could really do with a Thank You for being on the plane, helping us build it and fly it towards a brighter 2024 for all.
Fear not, we suspect that Allied Health Business Owners will lean in and step forward to take greater control of the disability service and success narrative next year.
Please rest up and take care of yourselves Allied Health Professionals, we have a lot of necessary work to do together next year. You know where we are when you’re ready for that chat.
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