Introduction: Why This Matters Now
Australia’s National Disability Insurance Scheme (NDIS) is on the brink of one of its most significant reforms since it began. Central to these changes is the introduction of a new Support Needs Assessment which will be linked to New Framework Plans. From mid-2026, participant needs will primarily be assessed through the I-CAN v6 tool (Instrument for the Classification and Assessment of Support Needs).
For Allied Health Business Owners, this reform brings disruption and opportunity in equal measure. Disruption, because the way participants access and justify their funding will shift dramatically. Opportunity, because businesses that adapt early can position themselves as trusted providers and advocates in this evolving environment.
This article explores what the reforms mean, how the I-CAN tool works, and the practical steps Allied Health businesses can take now to prepare and future-proof their operations. Read to the end to see our ten point plan to support you to get started.
Support Needs Assessment in the NDIS
What It Is
Support Needs Assessment is a structured process that identifies the type and intensity of supports a person with disability requires to live their life, participate in community, and achieve their goals. Until now, the system has relied heavily on participant-supplied reports from multiple Allied Health professionals—occupational therapists, speech pathologists, psychologists, and others.
The new model intends to create more consistency in decision-making, reduce the financial and administrative burden on participants, and establish a clearer pathway from support needs to budget allocation and funded services.
Why Now
The 2023 NDIS Review found rising costs, inconsistent planning, and inequitable participant experiences. In response, government committed to staged reforms, including mandatory support needs assessments for all participants aged 16 and over, development of a dedicated internal workforce of about 1,000 accredited assessors, and a fundamental shift away from impairment-based evidence toward a support-needs-based model.
The Timeline
The reform rollout is ambitious. Consultation, co-design, and pilot work with I-CAN v6 is happening throughout 2025. From mid-2026, participants will begin receiving staged invitations for their new assessments at plan renewal. Beyond that, older functional assessments will progressively be replaced, and support needs assessments will become the standard entry point for funding decisions. Whether every milestone is met on time remains to be seen—history tells us to be cautious.
The I-CAN Tool Explained
What It Is
The I-CAN tool was developed by the Centre for Disability Studies (CDS) and refined over two decades. It is grounded in the World Health Organisation’s International Classification of Functioning (WHO ICF), widely recognised as the gold standard for holistic, person-centred assessment. The tool is already in use in other programs, such as Disability Supports for Older Australians (DSOA).
The Structure
I-CAN covers 12 domains of life, ranging from mobility and self-care to mental health and interpersonal relationships. Each domain is broken into subdomains—four for most domains, and ten for the Physical Health domain. Physical Health is deliberately more detailed, including areas such as neurological, respiratory, cardiovascular, endocrine and metabolic, digestive, genitourinary and reproductive, musculoskeletal, skin and wound care, sensory health, and a final category for complex or rare medical conditions not otherwise captured.
Two scales are used to evaluate each subdomain. The first measures frequency (from 0, never, to 5, continuously). The second measures level of support required (from 0, independent, to 5, pervasive). The output is an “I CAN” statement, written in plain language, that describes what the person can do and what supports are needed.
What Comes Out
The I-CAN report produces a support intensity profile (scored from 0–10 per domain), a narrative that reflects strengths, preferences, and goals, and a structured foundation for the NDIA to translate into budgets. The tool therefore combines numbers with lived context—although significant concerns remain about how those numbers will convert to actual funding.
Implications for Allied Health Businesses
Changing Evidence Requirements
Traditionally, participants relied on multiple Allied Health reports to justify funding. In the future, the NDIA-organised I-CAN assessment will take centre stage for participants aged 16 and above, with additional reports only required for complex cases. This may reduce demand for standalone “NDIS evidence reports,” but it increases the importance of linking therapy and planning to I-CAN outcomes. Businesses should prepare for less report writing and more service planning connected directly to assessment results.
Workforce Shifts
The NDIA intends to establish a new in house cohort of accredited I-CAN assessors. Whereas previously we have providers completing assessments and the bias associated with this, we now have the funding agency completing assessments. While this workforce will sit outside private Allied Health businesses, in the event that they do recruit Allied Health Professionals, the shift may draw clinicians away from provider organisations and into NDIA or contracted roles. Business Owners should anticipate this “revolving door” effect and plan workforce strategies accordingly.
Service Planning and Delivery
Funding allocations will be tightly linked to the I-CAN domains using an unknown algorithm. This means participants may receive more modular supports—such as “communication supports” or “mental and emotional health supports”—rather than broad budgets. Allied Health businesses must learn to map their evaluations, goal-setting, and service offerings to these domains in order to demonstrate relevance and value.
Risks and Concerns
Advocacy groups such as PWDA and AFDO have raised concerns that a single tool risks oversimplifying complex needs. Participants may feel they have reduced choice and control if they cannot provide their own evidence from trusted clinicians. There is also little clarity about how assessment scores will translate into budgets. Allied Health providers should be prepared for anxiety among participants, their families and representatives, possible funding reductions, and the need to advocate transparently for fair outcomes. Business Owners might prepare budgets for several scenarios.
Navigating from Support Needs Assessments to Services.
It is anticipated that Support Coordinators will be replaced by Navigators and we hypothesise that they will play a critical bridging role in the translation of support needs assessments. While the I-CAN tool will be administered by accredited assessors appointed by the NDIA, it will probably be Navigators who help participants interpret what the assessment means for their goals, funding, and service mix over the course of their plan periods. Navigators will need to become fluent in the I-CAN domains, language and scoring outcomes so they can translate assessment outcomes into practical Plan implementation. They will also need effective and comprehensive knowledge of suitable services to link participants to.
For Allied Health businesses, this shift is significant. Navigators will increasingly influence which providers are recommended to participants, how budgets are allocated across domains and funding periods, and what services are prioritised. Businesses that can clearly map their services to I-CAN domains, communicate outcomes in participant-friendly language, and build strong relationships with navigators will be better positioned to attract referrals, partnership and maintain continuity of care. Conversely, providers who fail to align with the new framework may find themselves overlooked in favour of those who demonstrate a clear link between I-CAN results, participant goals, and measurable outcomes.
Plan Managers and I Can’t
For business owners, the shift in how plan managers operate under the I-CAN framework adds another layer of commercial and administrative pressure. With budgets tied more tightly to specific domains, owners will need to ensure their service descriptions, invoices, and outcome reports line up directly with the categories plan managers are required to monitor. Any misalignment could mean delayed payments, rejected invoices, or more back-and-forth with families and plan managers to justify services. This creates potential cashflow instability and increases the administrative workload for teams already stretched by compliance demands. On the other hand, owners who invest early in adjusting systems, retraining admin staff, and embedding I-CAN-aligned language into all client-facing documentation can position their businesses as “easy to work with,” building trust with plan managers and securing more consistent referrals and timely payments.
When Peak Advocacy Misses Providers
While peak bodies are providing commentary on the reforms, Allied Health Business Owners should be cautious about assuming these groups fully grasp the commercial realities of running a service. Peak bodies often focus on professional members rights, policy design, or professional standards, but they may overlook the day-to-day financial, workforce, and operational pressures that small and medium Allied Health businesses face. Business Owners need to interpret the reforms not only through the lens of policy or practice, but also through the commercial impact on cash flow, staffing, client acquisition, compliance costs, and long-term sustainability. In short, it is essential to recognise that peak body positions, while important, do not automatically translate into solutions for the real commercial challenges providers must manage. We strongly suggest that you keep them informed of your commercial challenges.
Stress Behind the Scenes
Amid the policy shifts and operational changes, it’s important not to overlook the stress these reforms place on Allied Health Business Owners themselves. Running an NDIS-focused service is already demanding, with constant pressures around compliance, staffing, client care, and financial viability. The uncertainty surrounding the Support Needs Assessment and I-CAN rollout only adds to that load. Questions about how funding decisions will be made, whether existing client relationships will be disrupted, and what revenue streams will remain secure can weigh heavily on owners. This level of uncertainty can lead to decision fatigue, increased risk aversion, and even burnout. Business owners need strategies not only for adapting their operations but also for protecting their own wellbeing, so they can lead their teams through change with clarity and resilience.
Strategies for Allied Health Business Owners
Build Literacy in I-CAN
Now is the time for business leaders and staff to become familiar with the I-CAN tool. Study the sample report, learn the domain structure, and align internal documentation with I-CAN language. The difference between talking about “support needs” that are directly related to “impairments” may seem subtle, but it will position your business in line with the new framework, referral requirements and market expectations .
Adapt Your Service Offerings
Reframe your services in terms of I-CAN domains. For instance, a speech pathology clinic could align its programs to the Communication domain, while an OT practice might map interventions to Mobility, Domestic Life, and Self-Care. Multidisciplinary businesses can create service packages that cut across domains, offering integrated solutions rather than isolated sessions.
Strengthen Internal Assessment Tools
I-CAN will sit alongside, not replace, the need for businesses to manage their own workforce capability, assessment and reporting protocols, client services, outcomes measures and satisfaction. Top of the list should be how to best collaborate with participants and stakeholders. Consider conducting a learning needs review across your team to identify professional development priorities. Use frameworks such as the Allied Health Capability Framework to benchmark skills, evidence based practice and a range of qualitative and quantitative outcome and satisfaction measurement tools. Prepare for your clinical data set to change as your client journey evolves to include a range of touch points now critical to both client and business outcomes.
Engage in Advocacy
Stay informed through NDIA updates, professional associations, and participant advocacy groups such as PWDA, AFDO, EAC and ANPA. Be prepared to reassure participants that their rights and supports will not be diminished. Continue to communicate with your local members of parliament and all relevant shadow ministers for NDIS, early childhood, small business, women. Position your business as not just a provider of therapy but as a voice for participants and providers navigating reform.
Manage Business Risk
The reforms will change revenue streams. Businesses should anticipate fewer fees from report writing and functional assessments and consider alternatives such as group programs, blocks of support and utilisation of AHA’s and disability support workers. Consider how your team and service mix can stretch to new markets, explore how your IP can be monetised, map B2B and B2G opportunities, partnership and consulting projects. We note that proactive Allied Health Business Owners have been working in this space for 18+ months. Staff wellbeing must be prioritised, as teams will face questions and anxieties from participants and their decision makers during the transition. They may have concerns for the future of their profession and their job security. Financial planning should include scenario modelling for participants at risk of reduced funding, workforce challenges, new service offers and more. Revisit your Risk Management documents and manage accordingly.
Future-Proofing in the Evolving NDIS
In the short term (2025–2026), businesses should focus on internal readiness: learning the I-CAN tool, piloting staff development initiatives, and embedding rights-based practice. Strategic planning for revenue diversification should be in play. By the medium term (2026–2028), service offerings could be fully aligned to I-CAN domains, with income diversified active across new opportunities. In the long term (2028 and beyond), businesses that embed I-CAN-informed service design, demonstrate workforce excellence, and actively participate in advocacy will be best positioned as trusted partners in a more consistent and sustainable NDIS.
Conclusion: Act Now to Stay Ahead
The introduction of the Support Needs Assessment framework and the I-CAN tool is not just another policy shift — it is a structural reform that will directly alter how Allied Health businesses operate within the NDIS. The risks are tangible: a reduced role for clinician-supplied reports, tighter funding tied to domains, potential delays in payment if invoicing is not aligned, and heightened stress for owners managing both compliance and workforce uncertainty.
For business owners, waiting to see how things unfold is not an option. Now is the time to build literacy in the I-CAN tool, review and reframe service offerings so they clearly align with the 12 domains, and embed I-CAN language across reports, invoices, and client communications. Administrative teams must be retrained to understand domain-based budgets, while practitioners need to adapt their goal-setting and progress reporting to match what support coordinators and plan managers will be working with. Owners should also stress-test their business models — modelling the impact of reduced demand for report writing and exploring alternative revenue streams such as group programs, consultancy, and B2B partnerships.
Perhaps most importantly, Allied Health leaders must step up as advocates. Participants will look to trusted providers for clarity and reassurance as the reforms roll out. Businesses that can confidently explain the changes, support clients to navigate the system, and demonstrate their value within the new framework will stand out as trusted partners. Those that hesitate may find themselves sidelined as coordinators and plan managers gravitate toward providers who are already speaking the language of I-CAN.
The message is clear: adapt early, realign services, strengthen systems, and engage with the reforms now. Allied Health businesses that act decisively will not only protect their financial sustainability but also help shape a fairer, more consistent, and more enduring NDIS for the future.
Ready to Navigate the I-CAN Era with Confidence?
Don’t wait for the reforms to catch you off guard. Take our free Biz Quiz today to uncover where your business is strong, where the gaps are, and what to prioritise next. It’s a practical way to benchmark your readiness for NDIS reform and get tailored insights into the steps that will future-proof your business.
Ten-Point Plan for Allied Health Business Owners
Get I-CAN Literate
Study the I-CAN domains and subdomains, review the sample report, and train your leadership team to understand the tool’s language and scoring system.
Reframe Services
Map your services explicitly to I-CAN domains so it is clear how your therapies align with the areas NDIA, support coordinators, and plan managers will be working with.
Update Documentation
Redesign service agreements, invoices, and reports so they use I-CAN-aligned categories. This reduces risk of payment delays and builds trust with plan managers.
Strengthen Admin Systems
Retrain administrative staff to understand domain-based budgets, and embed I-CAN categories into billing and client management software.
Scenario-Test Revenue
Model the financial impact of reduced demand for NDIS evidence reports. Explore alternative revenue streams such as group programs, consultancy, B2B contracts, or partnerships.
Build Coordinator Relationships
Position your business as “referral ready” by making it easy for support coordinators to see how your services connect to I-CAN outcomes and participant goals.
Work With Plan Managers
Develop strong relationships with plan managers by ensuring clear, compliant invoicing and proactive communication. Aim to become the provider that is “easy to approve.”
Invest in Staff Capability
Conduct internal learning needs assessments using the Allied Health Capability Framework. Provide training and supervision so staff can confidently talk with clients about I-CAN reforms.
Prioritise Owner and Team Wellbeing
Recognise the stress these reforms bring. Build support structures for yourself and your staff to avoid burnout — supervision, peer networks, and workload monitoring.
Step Up Advocacy
Engage with NDIA updates, peak bodies, and advocacy groups — but filter their positions through your commercial reality. Educate participants and families in plain language so your business becomes both a trusted service and a reliable voice.
