Coordinated Care at Risk Under Marketisation of the NDIS
9 August 2018 at 8:20 am
Coordinated care for people with disability is at risk under the marketisation of the National Disability Insurance Scheme (NDIS), with providers fearful information sharing could reduce their competitive edge, new research reveals.
The Centre for Social Impact at UNSW Sydney’s (CSI UNSW) latest report examined competition and collaboration between service providers in the NDIS, and found “the long established environment of goodwill and shared responsibility” between providers was under threat.
Report author, associate professor Gemma Carey, warned a lack of care coordination would diminish the overall quality of care provided under the NDIS.
“A lack of care coordination will be a major problem within the scheme if it can’t be supported. And we’re starting to see some of those really negative outcomes already,” Carey told Pro Bono News.
Carey said this could create problems for people with disability in custody, and could also mean people were not able to be discharged from hospital, as there would be no one clearly coordinating care for a person to be released into.
The impact of #NDIS on collaboration between providers
— CID (@nswcid) August 6, 2018
The report said while collaborative efforts were largely perceived to be continuing, there were signs organisations were shifting to “more competitive relationships” in the new “quasi market” created by the NDIS.
This could result in reduced trust and information sharing between providers, the report said, and have an effect on staff resources and time management.
The report warned this would have “significant implications for care coordination”.
“Being able to look holistically at a client’s needs and provide integrated services has in the past been achieved through organisations working together to coordinate care of an individual,” the report said.
“The new NDIS funding arrangements have meant that care coordination activities are not factored into personalised budgets leaving organisations with less resources to allocate to care coordination activities.”
Service providers interviewed for the study noted that sharing information had the potential to reduce an organisation’s competitive edge and viability.
One service provider respondent said: “I think that organisations are starting to understand that it’s a competitive environment and that collaborating and sharing your information may give away your competitive edge.”
Given the funding restraints on providers, Carey called on the social sector to work together to ensure care coordination did not diminish under the scheme.
“If providers can’t afford to fund [care coordination] themselves then it may not be able to happen,” she said.
“So I think there is perhaps a need for the sector to come together and raise this collectively, around the price of care coordination, to make sure it doesn’t drop off.
“It’s going to pose a lot of challenges to a lot of individual organisations.”