The National Disability Insurance Scheme (NDIS) was established. in 2013 Helping Australians with disabilities live more independently and participate more in work and community life.
This plan is not intended to save you money on health care, nor is it intended to replace health care.
However, it shows that it is possible under certain circumstances.
we are published This is the first study using large-scale data to reveal how the implementation of the NDIS affected participants’ use of the health system.
As the discussion continues about The cost and sustainability of the NDISHere’s what we found:
There are blurry lines
The NDIS provides: customized funding Ensure non-clinical support is available to people with disabilities. For example, this may include access to transport, a speech therapist or accommodation.
However, in practice, the line between non-clinical support and medical services can be blurry.
For example, some treatments provided by psychologists may be funded. Via NDIS or medicare.
This raises important questions about whether the NDIS has changed the way disabled people use the healthcare system.
The transition of some health services to the NDIS may reduce access to Medicare-funded health services.
However, if access to services is improved through the NDIS – e.g. transport to medical appointments – this allows people with disabilities to address previously unmet health needs and increase access to the healthcare system.
As the national debate over the cost and sustainability of the NDIS continues, we need to understand whether the scheme reduces or increases pressure on other sectors, particularly the stretched health system.
what we did
Our study used anonymous data from hundreds of thousands of people registered with the NDIS. We then linked that data to prescription use from the Pharmaceutical Benefits Scheme and medical services from the Medicare Benefits List.
We looked at visits to GPs, specialists, mental health services, allied health services and mental health prescribing. We have been working on this for up to 18 months since entering the scheme.
We compared NDIS participants living in areas where the NDIS was initially deployed with those who were later deployed. We assumed that the differences since launch were due to the NDIS.
What we found
The NDIS was not expected to affect services that only doctors can provide. Our results reflect this. We show that NDIS use did not have a significant impact on GP or specialist visits or mental health prescriptions.
However, the NDIS reduced subsidized mental health services (such as those provided by psychologists) by 13% per person per quarter. Another way to express this is that during the same period, the number of mental health services used per person was 0.0348 times lower.
For allied health services (e.g. speech or occupational therapists), per capita usage per quarter decreased by 8%, or 0.0165.
The decline in mental health or related health services may seem small. But as we scale up across the country and scale up in dollar amounts, the impact becomes more evident.
Let’s just assume about mental health services. average cost A$250 per session including Medicare rebate of $98.95. This means a copay of $151.05 per session.
After implementation of the NDIS, we calculated that annual Medicare spending was reduced by approximately $10.6 million and out-of-pocket costs were reduced by $16.3 million. This equates to $26.9 million per year. 700,000 NDIS participants.
What explains our findings?
Our findings suggest that mental health and related health support funded through the NDIS may replace some treatments previously available through Medicare.
Reductions in mental and related health services are more likely to suggest replacement rather than health improvement. This is because we expected changes in health status to be associated with changes in the first point of contact in the healthcare system (usually the GP), but we found no such changes.
One alternative reason is that the NDIS usually provided Broader, more fully covered services tailored to individual needs.
Previously, individuals depended on it. mental health treatment plan or Chronic Disease Management Plan Under Medicare, which offers limited visits and often involves out-of-pocket costs.
Our findings suggest that the expanded coverage and personalized nature of NDIS funding makes this a more attractive option for participants.
Read more: ‘Thriving Kids’ can help secure the future of the NDIS. But what does this program mean for children and families?
We do not yet know whether moving mental or allied health services to the NDIS will provide more benefits to participants than access through Medicare, or whether it will affect the government’s total costs for those services.
We also do not know whether total use of mental and allied health services funded by the NDIS or Medicare is increasing or decreasing. This is because no data was available when conducting the survey on the types of services used by NDIS participants.
How can we use our findings?
Some people have called the rising costs of the NDIS “eruption“. Some see the scheme as an investment that will deliver benefits across a variety of sectors, including early intervention for children with developmental issues to save employment or future support for participants and their carers.
Our study provides the first clear evidence on how the NDIS interacts with health services and shows that the social support it provides can relieve pressure on other services.
As the government considers the future of the scheme, understanding these cross-sectoral impacts will be key to building a sustainable NDIS that delivers support where it is needed most.
We would like to thank Dennis Petrie and Gang Chen, co-authors of the papers mentioned in this article.
