Worthy NDIS is failing to deliver

A fair go for all Australians requires a firmer foundation for the NDIS

This article by Craig Porte, Managing Director, Civica Care, first appeared in The Australian on May 7, 2019

They warned it would happen – and it is. Small, regional and rural disability service providers have been among the first to flounder, struggling to survive under the socially ground-breaking but inefficient National Disability Insurance Scheme (NDIS).

As a provider of IT systems for Australia’s many disability service providers, we’ve had a ringside seat to this unfortunate unfolding drama, which is already impacting so many Australians in need of support.

We side strongly with those who have already argued that reducing the spend by $1.6 billion on the NDIS, as announced in the federal budget last month, would go to much better use fixing the well-intentioned scheme’s flaws, in particular its outdated IT system and integration with the service providers.

Just as the National Disability Services (NDS) said when it stated that the NDIS is on the verge of failure, this ‘leftover’ $1.6 billion - now being absorbed into the government’s coffers - is a result of red tape. Not a lack of demand. Add to this the pricing problems and inefficiencies outlined by NDS and it’s no wonder that we see providers battling the system every day, while wondering how much longer they can last.

A shaky foundation

So what went wrong? The basics. NDIS is a great social reform but was built on the back of the Department of Social Services’ ageing Oracle Siebel system. It’s a 21^st century program on an outdated foundation.

When making claims for payment, providers are required to send export files through the NDIS claiming portal. The result? A $20 billion scheme is effectively manual in many key aspects.

This lack of IT system integration that would have allowed direct claims management and access to real time participant balances adds enormous overhead for our customers and other disability providers who are forced to navigate the NDIS.

To make matters more cumbersome, providers are wasting significant resources trying to find out why payment claims are being rejected or short paid by the system, as it offers little insight. This lack of transparency also extends to pricing under the scheme, which is prone to change with little notice, requiring rushed adjustments on the provider’s side.

The system also fails to disclose in real time an end user’s financial eligibility to receive services prior to them being delivered. If they have exhausted their allocated pot of funding under the NDIS, providers often do not know until they try to seek repayment for services delivered.

All of this increases the likelihood that service providers will fail to get paid for services. Combined with the already thin margins available under the NDIS’s standard pricing scheme and the change in business model from upfront to claim in arrears payments as well as a contested marketplace, providers are being left to draw on diminishing cash reserves.

We’re not alone on this. In the UK, where NHS disability claims are paid with reasonable efficiency through supply chain payments platform, Tradeshift, while payment claims for accommodation are paid through a myriad of less effective systems and suffer from all the problems of the NDIS here.

A mixed bag

We’re helping many providers to upgrade their systems in an attempt to manage the complexity and inefficiency of the NDIS, as they do all that they can to stay afloat. They tell us all kinds of stories about their experiences working under such a well-meaning but poorly executed scheme.

Without timely communication, limited business to government collaboration and shortened timelines, many regional and rural providers tell us they weren’t aware prior to the NDIS’s roll out just how much investment would be required. Their cash reserves are already lower than their metro peers and cash stress is amplified by the lack of claims management integration and a pricing model that fails to refund most travel costs.

Not only regional and rural but all providers have little left to invest in IT.

We must do better

The government should be lauded for having the vision to propose and implement a scheme like the NDIS. It’s a first world ambition to give better support to millions of Australians who live with disabilities. With the bipartisan support it has garnered, the scheme has the potential to be transformational for those in our community who live with disability and the family members and carers who support them. For now, it’s finding its feet and putting duress on many in the sector.

If disabled Australians are truly to be given a chance to be all that they can be, the NDIS must be improved – and that starts with setting it on a firmer IT foundation. It’s the government’s turn to step up to the plate.