In great news, the NDIA’s three-year pricing workplan, proposed in the 2024-25 Annual Pricing Review (APR), has been released. This workplan details the NDIA’s pricing approach through 2025-2028 and its evidence-based reviews. But on a practical level, what does it mean for NDIS providers?
In this post, we’re going to explain the three-year pricing workplan and share how the NDIA will conduct its evidence based reviews, so that you know (with as much certainty as is humanly possible in the NDIS) when pricing decisions will be made and what they entail for you and your business.
Unlike most things that the NDIA does, there is no acronym for the three-year pricing workplan, so we will simply refer to it as the workplan in this post.
How was the workplan developed?
Each year, the NDIA releases its APR and subsequent Pricing Arrangements and Price Limits (PAPL), with providers met with sudden price increases or decreases and little context as to why those decisions have been made. The three-year pricing plan is intended to make this process a whole lot more transparent.
A joint collaboration between the NDIS Quality and Safeguards Commission and the Department of Health, Disability, and Ageing, the three-year pricing workplan will balance the NDIA’s ‘need to address emerging market pressures with the importance of measured, evidence-based decision making.’
What does the workplan look like?
Each year, the workplan will build on the evidence gathered in the previous year, but it’s great to see that each year has clearly articulated actions; at quickclaim, we love an action point.
Year 1 (2025-2026): Immediate action and evidence building
In the first year, the workplan will develop the foundations for future pricing design, focusing on evidence building. This includes quality support pilots, targeted market analysis and the 2025-26 annual pricing review.
The 4 actions include:
- Annual Pricing Review: Core mechanism of stewardship
- Quality supports pilots: Building the evidence base
- Supported Independent Living
- Support Coordination
- Therapies
- Review of the application of Modified Monash Model and remote towns: Rural and remote reviews
- Implementation, stewardship and continuous improvement: Enhanced real-time market monitoring and interventions.
Year 2 (2026-2027): Evidence informed design and targeted implementation
In the second year, pricing approaches will be designed and tested. The 2025-26 annual pricing review, pilot insights, data and targeted consultation will inform these approaches..
The 5 actions include:
- Annual Pricing Review: Progressive implementation and market expansion
- Assistance in Daily Living
- Disability Support Workers
- Using pilot evidence to drive reform design: Application of pilot evidence
- Therapy pricing review: evidence integration and design
- Supported independent living pricing review: Integration and design
- Intermediary supports: Specifications and pricing.
Year 3 (2027-2028): Implementation and refinement
In the third year, the workplan will implement and consolidate the outcomes of the major reviews and monitor their early impacts. It will also prepare future stewardship cycles.
The 4 actions include:
- Annual Pricing Review: Integration and ongoing stewardship
- Supported independent living: Integration and refinement
- Therapy pricing review: Consolidation and evaluation
- Specialist disability accommodation (SDA) pricing review: consolidation and evaluation.
What does the workplan mean for you?
It’s a lot to take in, but the first step of the workplan is already underway, with the 2025-2026 APR consultation papers now available. The APR provider consultation paper focuses on five areas, including disability support worker services, support coordination, therapy supports, plan management, and social, community and civic participation.
Most importantly, as a provider, you can now make submissions for the 2025-2026 APR Consultations here. This is your opportunity to share your views and experiences around the above support categories, and provide feedback on the NDIA’s pricing arrangements. The workplan promised consultation and it’s delivered.
Interestingly, the APR consultation paper for providers also references differentiated pricing numerous times, a fact worth expanding upon.
What is differentiated pricing?
In its three-year pricing workplan, the NDIA alludes to its exploring differentiated approaches to pricing and market stewardship. It reflects that ‘pricing, policy and regulatory settings should respond proportionately to differences in service complexity, quality, workforce capability and participant outcomes.’
In short, the agency is investigating whether greater flexibility or ‘targeted adjustments’ can create a more sustainable market and deliver more quality supports for participants. The NDIA is looking at:
- Registration and assurance requirements
- Participant complexity and intensity
- Provider capability and quality
- Market alignment and benchmarking.
Nothing is happening now, but it’s worth keeping in mind, as the NDIA figures out how such approaches might be incorporated into future pricing frameworks.
What’s next?
The next big item on the agenda is the APR and subsequent PAPL, but the fact that you can already make a submission bodes well for the agency’s commitment to greater transparency. For now, we can make our submissions and see what tangible impacts they have on pricing going forward.
