Figure 3 - At the end of 2022, around 30% of participants self-manage all or part of their plans. This increases to 40% for early childhood supports, where parents and carers self-manage on their child's behalf.
Graph showing the proportion of participants by plan management status and by age group at the end of 2022
- For participants aged 0 to 6 years, 34% are fully self-managed, 6% are partly self-managed, 53% are plan-managed and 7% are agency managed.
- For participants aged 7 to 14 years, 36% are fully self-managed, 9% are partly self-managed, 45% are plan-managed and 10% are agency managed.
- For participants aged 15 to 18 years, 28% are fully self-managed, 8% are partly self-managed, 54% are plan-managed and 9% are agency managed.
- For participants aged 19 to 24 years, 17% are fully self-managed, 8% are partly self-managed, 61% are plan-managed and 14% are agency managed.
- For participants aged 25 to 34 years, 11% are fully self-managed, 6% are partly self-managed, 65% are plan-managed and 17% are agency managed.
- For participants aged 35 to 44 years, 10% are fully self-managed, 6% are partly self-managed, 68% are plan-managed and 16% are agency managed.
- For participants aged 45 to 54 years, 9% are fully self-managed, 5% are partly self-managed, 70% are plan-managed and 16% are agency managed.
- For participants aged 55 to 64 years, 9% are fully self-managed, 5% are partly self-managed, 71% are plan-managed and 15% are agency managed.
- For participants aged 65 years and over, 10% are fully self-managed, 7% are partly self-managed, 67% are plan-managed and 17% are agency managed.
- Across all age groups, 23% are fully self-managed, 7% are partly self-managed, 58% are plan-managed and 12% are agency managed.
Figure 6 - An overview of the range of market tools government can use to ensure the effective delivery of supports and, ultimately, outcomes for participants
Infographic showing three categories of market tools that governments, as market stewards, can use to better ensure effective delivery of supports and outcomes for participants
- Market coordination which can include: market facilitation; market intermediaries; and market deepening.
- Market settings which can include: market access settings, and pricing and payment approaches.
- Alternative commissioning, which can include: direct, community and integrated commissioning; and provider of last resort arrangements.
Figure 7 - Market stewards can use a mix of market-based tools to achieve the following objectives for the NDIS market
Infographic showing three objectives for the NDIS market, and the market-based tools that can be used to achieve them.
- Access to supports and continuity of supply. This objective is impacted by market access settings, alternative commissioning and provider of last resort settings.
- Participants have informed choice and providers are responsive to participants’ needs. This objective is impacted by: market coordination (including market facilitation and market deepening tools); as well as pricing and payment approaches.
- Providers and intermediaries innovate and invest in the capability of participants. This objective is impacted by pricing and payment approaches; and market coordination (including market facilitation and the role of market Intermediaries).
Figure 15 - NDIA’s transition steps for removing price caps … has barriers hindering progress at each step
Infographic outlining NDIA’s four transition steps for removing price caps, and the barriers hindering progress for each step of this transition.
Step 1: Expand supply and satisfy short term demand during the transition to full scheme. Step 1 barrier: Difficulty in setting the ‘efficient’ price caps.
Step 2: Invest in the information infrastructure needed to support the operation of the market. Step 2 barrier: No infrastructure in place to provide sufficient visibility of all transactions.
Step 3: Monitor markets closely for sign of shortages and other market failures. Step 3 barrier: No transparent process for market monitoring, creating uncertainty is a barrier to this.
Step 4: Deregulate as appropriate, including removing price caps when they are no longer binding. Step 4 barrier: Price caps are an anchor point is a barrier to this.
Figure 16 - Level of intervention by government on pricing
Infographic outlining different decreasing levels of intervention by government on pricing.
Most intervention – involves price setting and price approval:
- Price setting:
- Steward set prices
- May include setting limits on prices or the allowed rate of return/revenue
- May also include setting prices relative to the observed market rate.
- Price approval:
- Providers are required to submit their prices to the regulator for approval.
- Similar to current quotation system for AT
- High compliance costs.
Less intervention – price monitoring:
- Steward monitors and reports on actual market transaction prices
- Stewards can ‘force’ provider’s price information.
Least intervention – price information:
- Participants provided with price information to help with decision-making
- Some discipline on provider pricing behaviour.
Figure 18 - The risk of a price and volume ratchet effect
Flowchart indicating the risk of a price and volume ratchet effect through six steps.
Steps:
- Remove price caps
- Providers seek to increase prices and volume of supports delivered
- Participants have inadequate ability and incentives to constrain provider behaviour
- Price and volume of supports rise (which may not be linked to improved outcomes)
- Participants have insufficient funding to purchase required supports
- Plan reviews lead to increased participant budgets
Step 6 loops back up to Step 2 – where providers seek to increase prices and volume of supports delivered.