NDIS Group Services Pricing Update and Best Practices to Transition Smoothly

The NDIS Group services pricing change from ratio-based to apportioned pricing will be revolutionary.

As per the latest NDIS announcement, ‘the transitional pricing arrangement line items will not be phased out until December 2023. This allows providers time to:

• better understand the pricing arrangement and the changes
• access the additional guidance for group-based social and community participation supports that will accompany the PAPL update, and
• access additional resources to support transition as they become available in the coming weeks and months.’

So, there’s lots to do before the transition; also, the NDIA has stated that the extension should not be a reason to procrastinate as ‘there are no further extensions planned’. It is a calculative transition that will significantly affect the entire cash flow & working of the organisation’s group services. Providers must review the changes, justify their decision and communicate the new pricing model to the participants. This communication is essential for peace of mind on both ends (participant & provider).

What is apportioned pricing model?

Apportioned pricing is also called ‘Divided Pricing’, where we have a fixed hourly rate which is multiplied to support workers’ time and divided among the participants.

The ‘flat rate’/’fixed rate’ that you decide for the service, unlike ratio-based pricing, doesn’t pay for everything. All the overheads and extra support activities are charged separately to the participant. Hence, with careful re-design of the services, the new apportioned services will match the previous ratio-based, plus it will cover the additional costs like capital costs (rent), bills, computers/technology costs, etc.

Benefits of transitioning

This model can offer many benefits for both participants and businesses. Some of them are:

Increased flexibility & transparency

Providers can now charge separately for NDIS line items such as Centre Capital Costs (CCC), extra 1:1 support and Non-face-to-face (NF2F) services which are added to the group services. With the ability to charge separately for additional costs, providers can offer more flexible support arrangements to participants. This can include personalised support plans that meet each participant’s specific needs and preferences. Participants get precisely what they are paying for and have more control over their support costs. This increases transparency and trust between the participant and the provider.

Improved budgeting

Providers can create a Program of Support (POS) for up to 6 months or a similar amount of sessions (provided that the participant has an opportunity to regularly review the program), allowing for better budgeting and cash flow management. This helps prevent organisations from running out of pocket or incurring financial losses.

Better tracking of expenses & increased profitability

The apportioned pricing model allows providers to track expenses more accurately, which helps them identify areas where they can reduce costs and improve efficiency. By charging separately for additional costs, providers can increase their profitability while also providing more flexible and personalised support arrangements to participants.

Challenges of transitioning

Transitioning to a new apportioned pricing model can offer many benefits, but it’s not without challenges. Here are some key hurdles to consider before planning for your transition:

Designing group services

To make the apportioned transition work, you must create group services that align with all the participants’ common goals. This requires carefully calculating line items and tailoring them to each participant’s needs. This can be time-consuming and require a lot of administrative work.

Documenting group progress notes & claiming

At the end of every session, staff members must document progress notes for each participant. Although the POS benefits from claiming after each session, claiming for group sessions requires accuracy. You must keep track of all the additional line items you provide for each participant aside from the common group sessions and charge them. This can become repetitive work, especially if you manually enter each participant’s notes and invoices.

Planning recurring schedules

If you plan to create a POS, you’ll need to assess and plan for recurring schedules while assigning the correct staff for the entire planned period. This can be a complex task that requires careful planning and management.

Despite the challenges, some best practices and solutions are available to smooth the transition.

Best Practices

When implementing new apportioned pricing changes, following best practices is important. First, obtain the consent of the participants to ensure they have choice and control over the services they receive. The apportioned pricing model allows for greater flexibility and individualised support, which aligns with the participant’s NDIS goals. Participants should be informed of this flexibility, and their consent should be documented.

To avoid budgetary issues resulting from participant cancellations or changes, it is recommended to implement a Program of Support with fixed rates for common services. Streamlining administrative tasks by automating recurring tasks, like creating appointments, can help increase efficiency. Proactively documenting and claiming progress notes frequently is crucial to reduce administrative workload further and improve cash flow. Moreover, collaborating with support coordinators, plan managers, LACs, and associated organisations can create a more collaborative environment for all parties involved.

Why do NDIS group services need case management software for the smoothest transition?

Using case management software that automates rostering helps you eliminate repetitive manual tasks every week. An ideal software should offer a progress note documentation feature with multiple line item calculation, which allows you to accurately record the time and details of each service delivery for every group participant. Besides, the bulk claim submission feature can also help you streamline the invoicing process and reduce the administrative burden.

Some software offer features specific to group services like group rostering, group progress notes, data sharing, and more for better managing group services, allowing you to focus on service delivery while improving performance management. A multiple line items feature allows you to design your services as per your organisation’s offerings, which would be followed by planning sessions with group appointments.

This is how case management software can help your business transition smoothly from an existing ratio-based pricing model to apportioned pricing, ensuring peace of mind and benefit to both participants and providers.

If you’re interested in a case management system, you can visit Comm.care by Pnyx, a case management system designed to simplify the management of group activities and track participant progress in real-time.