Submission 3173 — Mr Peter Brady (Attachment 1) — NDIS Future Generations Bill | External submission

SUBMISSION TO THE SENATE COMMUNITY AFFAIRS LEGISLATION

COMMITTEE

Inquiry into the National Disability Insurance Scheme Amendment

(Securing the NDIS for Future Generations) Bill 2026

Market Failure, Pricing and Structural Sustainability

Submitted by: Peter Brady, NSW

Date: July 2026

Confidentiality: This submission is intended to be treated as a public document.

Executive Summary

83.4 per cent of NDIS providers charge at the maximum Price Limit. The last publicly available benchmarking of provider cost structures was published in May 2022. Parliament is being asked to reshape participant funding within a scheme that paid $46.04 billion to providers and participants in 2024-25 (NDIA payment data) - without current data on where the money goes.

I support the objective of securing the NDIS for future generations. However, this Bill focuses predominantly on participant budgets while leaving largely unaddressed the structural market conditions that drive support costs.

This submission proposes a specific, implementable mechanism: a transparency linked dual-cap pricing structure, grounded in the UK Behavioural Insights Team’s EAST framework (Easy, Attractive, Social, Timely), under which:

providers who participate in standardised annual overhead benchmarking retain access to the current Price Limit;
providers who refuse transparency are subject to a lower cap set at the sector median; and
proven behavioural tools - peer comparison, friction, progressive tightening - drive efficiency without reducing participant supports or support worker wages. To illustrate the scale of opportunity: the NDIA’s 2020-21 Financial Benchmarking Survey (Deloitte Access Economics) found overheads averaged 44.2 per cent of direct labour costs. Applied to $46.04 billion in scheme payments, if the mechanisms proposed in this submission reduced the mean overhead ratio to the existing sector median of 35.9 per cent, the annual saving would be approximately $2 billion - without reducing a single hour of participant support or a single dollar of support worker wages.

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This is not a request for further study. It is a complete policy proposal with mechanism design, safeguards, transition arrangements and implementation sequencing.

Section 45C of the Bill grants the Minister authority to make pricing determinations by legislative instrument. The Bill already contemplates different maximum amounts for different kinds of providers (subsection 45C(9)(b)) and requires pricing advice to consider the cost of safe, efficient provision (subsection 45C(14)(a)). The dual-cap mechanism proposed in this submission provides the methodology through which these existing powers should be exercised. Without standardised benchmarking, the NDIA cannot advise the Minister on what “efficient” actually means, and pricing determinations become assertions rather than evidence.

As the parent of a participant with highly complex support needs, my experience is that many of the Scheme’s largest costs are not primarily driven by participant choice. They are influenced by market settings, pricing structures, provider overheads and participant constraints that participants have little ability to influence.

This submission should be read alongside my separate submission addressing participant safety, functional capacity and duty of care.

The Central Question The Bill’s stated purpose is to help secure the NDIS for future generations. This raises a fundamental policy question: can the NDIS be secured solely through tighter control of participant funding, or must sustainability also address the market conditions that influence the cost of delivering supports?

Many current reforms focus on participant plans, reassessments and funding decisions. These measures may constrain expenditure. They do not address the underlying factors that determine the price of support.

Sustainability Requires More Than Funding Reductions The central question should not be: how can the NDIS spend less? The more important question is: why does disability support cost what it costs?

In my family’s circumstances:

a typical week of support costs approximately $9,000;
a standard weekend of Short Term Accommodation costs approximately $9,000;
a public holiday weekend can exceed $15,000; and
a single week of Short Term Accommodation can exceed $25,000. There is no dedicated 2:1 support price within the NDIS pricing framework. Where two support workers are required, providers apply two 1:1 rates simultaneously. Four weeks of Short Term Accommodation across a year - a modest and reasonable support for a person with significant disability - can cost approximately $100,000. That figure raises a

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legitimate question about whether current pricing structures accurately reflect the underlying cost of delivering those supports.

Why These Costs Fail the Pub Test If a family hears that one week of Short Term Accommodation can exceed $25,000, the natural question is not: should the participant receive support? The natural question is: why does it cost so much?

The long-term sustainability of the NDIS depends not only on controlling expenditure but on maintaining public confidence that expenditure delivers value. The question is whether observed costs are the unavoidable consequence of disability support, or partly the product of structural weaknesses in the way the market operates.

Structural Issue - Market Design and Participant Constraints In parts of the Scheme, three conditions exist simultaneously:

high switching costs;
administered pricing; and
participant constraints in complex support environments. For participants with complex needs, changing providers is often impractical. Providers develop detailed knowledge of communication methods, behavioural strategies, medical conditions and risk management. Replacing that knowledge involves risk, disruption and significant transition costs. The result: participants may technically have choice but have limited practical ability to exercise it. The Scheme operates less like a competitive market and more like a quasi-administered system without strong cost discipline.

Choice and Competition May Be Weaker Than Intended The NDIS was built on the principle that participant choice would encourage competition. The NDIA’s own 2020-21 Financial Benchmarking Survey found:

83.4% of providers always charged at the NDIS Price Limit;
15.7% sometimes charged below the Price Limit; and
only 0.9% always charged below the Price Limit. If competitive pressures were consistently driving prices downward, a larger proportion of providers would charge below the maximum. Instead, Price Limits appear to operate as de facto market prices in many support categories. This does not indicate inappropriate provider behaviour - it reflects the interaction of administered pricing, participant constraints and limited competitive pressure.

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I acknowledge this data is from 2020-21. If updated benchmarking has been published, I welcome the Committee’s consideration of whether patterns have materially changed. If no subsequent survey has been conducted, this itself warrants attention.

For participants with highly complex needs, changing providers requires retraining an entire workforce, rebuilding trusted relationships, transferring behavioural and medical knowledge, and accepting significant operational risk. Participant choice alone cannot ensure efficient pricing in these markets.

Pricing Structures Require Closer Examination Participants requiring 2:1 support frequently incur approximately double the participant-facing cost of participants receiving 1:1 support. The increase in labour costs is obvious. However, many organisational costs do not increase proportionately.

Providers are not generally operating:

twice as many offices;
twice as many payroll systems;
twice as many rostering systems;
twice as many finance teams;
twice as many compliance systems; or
twice as many management structures. Many overheads remain largely unchanged. Does doubling the participant-facing charge accurately reflect the marginal cost of providing a second support worker, or does it unintentionally overstate the cost of supporting participants with the most complex needs?

To distinguish properly: worker-specific overheads (payroll processing, insurance, supervision per worker) legitimately double with a second worker. Participant-specific overheads (care coordination, compliance per participant) do not. Organisational overheads (rent, IT systems, executive salaries) are fixed regardless of support ratio. It is the third category - fixed organisational overhead - that does not increase yet is effectively charged twice under current pricing structures.

To illustrate the real-world scale: my son is 25, lives at home, and receives 2:1 support while awake and 1:1 overnight. That support currently costs approximately $10,165 per week. If overhead were charged once rather than doubled for the organisational component, the same hours with the same two support workers would cost approximately $7,036 per week - a saving of $3,129 per week, or $156,435 per year. Same hours. Same two workers. Same participant. The only difference: not charging fixed organisational overhead twice.

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This single correction, for one participant, would save more than the annual NDIS plan of many participants with moderate support needs. Applied across all participants receiving 2:1 support, aggregate savings would be substantial.

Parliament should satisfy itself that the assumptions underpinning this pricing approach remain economically justified. The standardised benchmarking methodology proposed in this submission would provide the evidence base to make that determination.

Why Overhead Benchmarking Matters - And Why Current Benchmarking Is

Insufficient

The largest opportunities for efficiency are not in worker wages. They are in overhead structures.

The NDIA’s 2020-21 Financial Benchmarking Survey (Deloitte Access Economics, May

confirmed this:

overheads averaged 44.2 per cent of direct labour costs;
non-service level staff wages (management, administration, corporate) represented 37.5 per cent of total overheads;
overhead ratios varied from 21.8 per cent (25th percentile) to 56.3 per cent (75th percentile); and
average EBITDA was 13.3 per cent of total costs. This survey - published May 2022 - is the last publicly available benchmarking. The NDIA itself confirmed on its website that it “is not running the 2022-2023 financial benchmarking survey.” Parliament is being asked to reshape participant funding within a $46.04 billion scheme on the basis of overhead data that is now five years old, and the NDIA chose not to update it.

Before reducing participant supports, it is reasonable to ask whether the Scheme fully understands how much of high-cost supports relate to direct support worker wages, supervision and management, compliance and administration, technology platforms, property costs, and other overhead allocations. Without this transparency, policymakers risk focusing on participant budgets while overlooking system-wide efficiencies.

The Benchmarking Gap: No Standardised Overhead Allocation Methodology

The benchmarking that was conducted measured overheads at the whole-of organisation level. It did not require a standardised allocation methodology - such as apportioning total organisational overheads across all frontline staff on a per-FTE basis, across all services delivered by the entity - including NDIS-funded services, non-NDIS services, and charitable or community activities.

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Without this, the data cannot answer the critical question: for a given participant receiving a given level of support, what proportion of the price charged relates to overhead, and is that proportion reasonable?

A per-FTE allocation basis applied across all services is essential because it is resistant to gaming. Providers cannot manipulate a headcount-based allocation in the way they can manipulate discretionary cost categorisation or shift costs between NDIS and non NDIS service lines.

The implications of this gap for participants requiring higher support ratios are discussed further above (see Section 6).

Using Benchmarking to Drive Efficiency: The EAST Framework

Providers already retain the difference between the Price Limit and their costs. This should incentivise overhead reduction. It does not - because the incentive operates in an information vacuum. No provider faces any consequence for high overheads because no comparative data is visible.

Behavioural economics - particularly the work of Thaler and Sunstein on “nudge” theory

demonstrates that making performance data visible changes behaviour, even without direct regulation. The 83.4 per cent of providers charging at the Price Limit is the predictable result of a system where the maximum price is the only visible reference point, anchoring pricing upward, with no social norm around efficiency because no comparison is possible.

provides a proven structure for designing interventions that shift behaviour without heavy-handed regulation. Applied to NDIS provider benchmarking:

Easy: Make Efficient Pricing the Path of Least Resistance - and Add Friction to

Maximum Pricing

Currently, charging at the Price Limit is entirely frictionless. No explanation is required. No justification is sought. The system is designed so that maximum pricing is the easiest option.

The Behavioural Insights Team’s research demonstrates that even trivial friction - a single additional step, a required explanation, a moment of pause - significantly reduces the frequency of a behaviour.

Any friction must be applied at the provider level - at the point of price-setting or registration - not at the point of claiming. Friction at the claiming stage falls on self managed participants, who already bear the cognitive and administrative burden of managing their own plans.

Applied here:

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providers whose overhead ratio exceeds the sector median could be required to submit a brief annual explanation as a condition of registration - not an audit, but a statement of reasons that creates accountability. The act of explaining creates reflection;
provider pricing could be required to be published alongside the sector median for that support category - empowering self-managed participants, plan managers and support coordinators before they engage a provider; and
registration and compliance requirements could be streamlined for providers demonstrating below-median overheads - reduced audit frequency, simplified reporting, faster payment processing. The principle is not punishment. The principle is that the system should make efficient pricing easy and maximum pricing require a moment of conscious justification - and that this justification should fall on the provider, not the participant.

Attractive: Make Transparency Directly Rewarding Through Transparency-Linked

Pricing

The most powerful mechanism is to link pricing access directly to participation in benchmarking. This submission proposes a two-tier pricing structure:

Tier               Who Qualifies                       Price Cap

Tier 1 Providers who submit standardised annual Current NDIS Price Limit overhead data using per-FTE allocation across all services

Tier 2                    All other providers                        Sector median for each

support line item

The condition for Tier 1 is participation in standardised benchmarking - not performance. A provider with genuinely high costs who participates and explains retains Tier 1 access. A provider who refuses to be measured defaults to Tier 2.

The principle: the price of opacity is a lower price cap.

This mechanism solves multiple problems simultaneously:

it makes benchmarking self-sustaining - providers voluntarily participate because the alternative is a lower cap;
it reverses the current incentive structure - transparency is directly rewarded, opacity is costly;
it generates the comprehensive, current dataset that replaces the five-year-old survey; and
it is legally defensible - no provider is penalised for their cost structure, only for refusing transparency.

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The Tier 2 cap should be set as a single price per support line item - not variable by provider size. A single cap creates uniform competitive pressure, avoids gaming of size band thresholds, and allows sole traders - who have no organisational overhead by definition - to drive the median downward over time. Sole traders are the efficient frontier made visible, and their presence is the strongest natural driver of downward price pressure. The sector median recalibrates annually. As providers respond to transparency and competitive pressure, the median itself falls, creating continuous efficiency improvement without additional regulatory intervention.

As a condition of Tier 1 access, providers should be required to lodge their pricing schedule annually with the NDIA. Providers do not currently lodge prices - the Price Limit operates as a ceiling and providers set their own prices without disclosure. Requiring Tier 1 providers to lodge their pricing creates transparency, enables real-time monitoring, and provides the data necessary for median calculations and peer comparison. The act of formally lodging a price above the sector median - and seeing that comparison at the point of lodgement - is itself a behavioural intervention.

Progressive tightening - announced in advance, moving the Tier 2 cap from the median toward the 25th percentile over a defined period - provides clear forward guidance to the market.

Safeguards are essential:

providers below a revenue threshold (e.g. $1M NDIS revenue) qualify for Tier 1 via a simplified annual declaration - total overheads, total FTE, overhead per FTE;
providers in NDIA-declared thin markets automatically qualify for Tier 1 - market continuity outweighs data collection where supply is limited; and
a 12-month transition period applies before Tier 2 takes effect. Rather than accommodating higher small-provider overheads through a variable cap, the more productive approach is to reduce those overheads directly. Government provided or subsidised shared services - payroll, rostering, invoicing, compliance systems - available free to providers below a revenue threshold would eliminate the fixed technology costs that disproportionately burden small providers.

Under yardstick competition principles, providers within Tier 1 are not compared against their own historical costs - which creates no incentive to improve. Instead, each provider’s overhead costs are benchmarked against the efficient frontier of comparable providers. Over time, the benchmark itself improves as the sector moves toward greater efficiency.

International precedent: Transparency-linked pricing is not untested. NHS England requires every trust to report standardised costs against national benchmarks as a condition of full tariff access. Dutch municipalities set disability support prices at sector

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medians derived from mandatory provider cost reporting. This submission applies the same principle - transparency as a condition of pricing access - within the existing NDIS market framework.

Nudge plus architecture, not nudge alone.

The ATO’s real-time nudge messaging program, evaluated through randomised control trial, found that taxpayers who received a peer comparison prompt were 2.5 times more likely to review their return and 3 times more likely to adjust their data (APSC, State of the Service Report 2024-25). In 2023-24 alone, 712,000 nudge prompts protected an estimated $92.6 million in revenue - without a single audit or penalty.

The same behavioural principle applies to provider overhead transparency. Applied here: confidential quarterly reports showing each provider where their overhead ratio sits relative to comparable peers - by size, service type and region. This leverages:

descriptive social norms - “this is what comparable providers are doing”;
loss aversion - providers above the median perceive themselves as underperforming; and
accountability - the knowledge that their position is measured and observed. A provider informed that their overhead ratio of 52 per cent exceeds the sector median of 35.9 per cent is not being penalised. They are being given information. The dual-cap mechanism provides the consequence that makes the information actionable.

Providers whose overhead costs exceed the median are required to provide an explanation as to why - not as a punitive measure, but as an accountability mechanism. The act of explaining creates reflection. The knowledge that an explanation will be required changes the decision that precedes it.

The ATO’s own assessment notes that adding more nudge messages may diminish their impact - reinforcing that the dual-cap mechanism is essential. The cap is not just a nudge; it is the structural consequence that makes the nudge sustainable over time.

Timely: Intervene at the Moment of Decision

Behavioural interventions are most effective when delivered at the point of decision not as abstract annual reports filed and forgotten:

at the point of price lodgement: when a Tier 1 provider lodges or updates their pricing schedule, the system displays where their pricing sits relative to the sector median;
at registration renewal: requiring providers to review their benchmarking position as part of the renewal process;

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following Award or Price Limit changes: providing benchmarking data showing how peers have responded - the optimal moment to influence pricing decisions; and
progressive benchmark tightening announced in advance: similar to emissions reduction trajectories, the announcement of future standards drives current investment.

Sequencing: Benchmark Before You Cut

If participant funding is reduced before these mechanisms are established, providers absorb cuts through service reduction rather than overhead improvement. If benchmarking and behavioural mechanisms come first, future funding adjustments can be calibrated to demonstrated efficient costs rather than arbitrary reductions.

The recommended sequencing is:

establish standardised per-FTE benchmarking and implement transparency- linked pricing tiers;
require Tier 1 providers to lodge pricing schedules annually;
introduce confidential peer comparison reports and publish median pricing;
allow 12-18 months for behavioural mechanisms to take effect; and
calibrate future pricing decisions based on demonstrated efficient costs. Parliament should ask:
why has benchmarking not been repeated since 2020-21?
why does it lack a standardised per-FTE allocation methodology across all services?
why are providers not required to lodge their pricing or explain overhead costs that exceed the sector median?
why are behavioural tools used successfully by the ATO not being applied to NDIS provider pricing? Parliament should not accept a sustainability framework that asks participants and families to bear the burden of cost reduction while the system operates without current benchmarking, without standardised cost allocation, and without the behavioural mechanisms proven to drive efficiency in comparable regulated markets.

Implications for Fairness and Sustainability Participants with limited ability to influence costs are being asked to absorb funding reductions while the system itself does not effectively constrain pricing.

In my own circumstances, if my son’s funding is reduced to the level currently proposed, our family would be left with approximately 34 hours of funded support per

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week. In practical terms, this would likely require me to leave the workforce and assume a full-time caring role.

Where participant funding is reduced but support needs remain unchanged, the apparent saving to the Scheme is achieved by transferring costs from funded supports to unpaid family carers. The support need has not disappeared; it has been shifted elsewhere. Those cost transfers also reduce workforce participation, family income and tax revenue, while increasing carer burden.

Strengthening Competition Where Market Forces Are Weak In high-cost or thin markets - such as Supported Independent Living, complex Short Term Accommodation, and other specialist support environments - government supported commissioning arrangements could allow providers to compete through structured tender processes (section 73EA of the Bill). This enables genuine price competition without requiring participants to continually change providers.

Parliament could also consider models that aggregate demand regionally or by participant cohort, establish preferred provider panels, preserve participant choice within those panels, and create greater collective bargaining power.

Addressing the Anticipated Objection Some providers will characterise this proposal as regulatory burden. The objection does not withstand scrutiny. The Tier 1 requirement is a standardised annual declaration - total overheads, total FTE, overhead per FTE - materially less burdensome than existing registration, practice standards audits, and financial reporting obligations these providers already meet. No provider is penalised for having high costs. The mechanism targets opacity, not cost levels. Any provider willing to be measured retains full pricing access. The only providers disadvantaged are those who refuse transparency - and the Committee should ask why any provider would refuse, if their costs are justified.
Recommendations

Concordance: Recommendations and Bill Provisions

Recommendation           Primary Bill Provision            Purpose

Rec 1: Dual-Cap Pricing               s.45C(9)(b); s.45C(14)        Transparency-linked pricing

tiers

Rec 2: Legislate the Mechanism     s.45C (amend)               Parliamentary oversight of

pricing

Rec 3: EAST Framework              s.45C(14); s.118(1)           Behavioural pricing tools

Rec 4: 2:1 Pricing Review            s.45C; pricing rules         Overhead methodology

review

Rec 5: Standardised Benchmarking   s.45C(14)(a)                Evidence base for pricing

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Recommendation Primary Bill Provision Purpose

Rec 6: Market Design Review         s.73EA; market steward      Thin market competition

functions

Rec 7: Sequencing                   s.34A; s.45C                 Provider efficiency before

cuts

Rec 8: Annual Reporting              s.118(1)(baa)              Ongoing Parliamentary

oversight

Recommendation 1: Transparency-Linked Dual-Cap Pricing (sections 45C(9)(b) and 45C(14))

The Committee should recommend that the NDIA implement a transparency-linked pricing structure under which:

(a) providers who participate in standardised annual overhead benchmarking - using a per-FTE allocation methodology across all services delivered by the entity, including NDIS-funded services, non-NDIS services, and charitable or community activities - retain access to the current NDIS Price Limit (Tier 1);
(b) providers who do not participate are subject to a lower price cap set at the sector median for each support line item (Tier 2);
(c) Tier 1 providers are required to lodge their pricing schedule annually with the NDIA;
(d) providers whose reported overhead costs exceed the sector median are required to provide a brief annual explanation;
(e) providers below a specified revenue threshold qualify for Tier 1 via a simplified annual declaration - total overheads, total FTE, overhead per FTE;
(f) providers in NDIA-declared thin markets automatically qualify for Tier 1;
(g) a 12-month transition period applies before Tier 2 takes effect; and
(h) the Tier 2 cap is subject to announced progressive tightening over a five-year period, moving from the sector median toward the 25th percentile. Rationale: This mechanism creates a self-sustaining incentive for provider transparency, generates the standardised cost data necessary for evidence-based pricing decisions, and enables the deployment of behavioural tools proven to drive efficiency in comparable regulated markets - without reducing participant supports, without reducing support worker wages, and without requiring heavy-handed regulatory intervention.

Recommendation 2: Legislate the Transparency-Linked Mechanism Under Section

45C

The Committee should recommend that the transparency-linked dual-cap mechanism be legislated as a requirement of any pricing determination made under section 45C

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not left to Ministerial discretion. Specifically, section 45C should be amended to require that:

(a) pricing determinations must provide for at least two tiers of maximum amounts for each support or class of supports, structured by participation in standardised benchmarking (subsection 45C(9)(b));
(b) the NDIA must publish annually the results of standardised benchmarking, including sector median overhead ratios and a standardised allocation of overhead costs across all services delivered by the entity (NDIS, non-NDIS, and charitable activities); and
(c) the Minister must not make a determination that reduces the Tier 1 maximum amount below the level necessary to fund safe, efficient provision as evidenced by current benchmarking data, unless the benchmarking demonstrates the existing amount materially exceeds that cost and the reduction would not create foreseeable risks to participant or worker safety. Rationale: Section 45C grants pricing authority without disallowance, without mandatory consultation, and without a legislated requirement for evidence-based methodology. Pricing determinations under s.45C are legislative instruments that explicitly exclude sunsetting under the Legislation Act 2003 and are not subject to Parliamentary disallowance. The “have regard to” obligation in subsection 45C(17) is the weakest form of statutory constraint in Australian administrative law. Legislating the mechanism ensures pricing decisions are grounded in current benchmarking evidence, protects efficient providers from arbitrary price reductions, and survives changes of government. The Government asks participants to accept funding reductions in the name of sustainability. It is not unreasonable to ask that the pricing mechanism through which those reductions are implemented be legislated, transparent, and evidence-based.

Recommendation 3: EAST Framework Implementation

The Committee should recommend that the NDIA adopt the UK Behavioural Insights Team’s EAST framework (Easy, Attractive, Social, Timely) as the design basis for provider pricing interventions, including:

(a) publishing provider pricing alongside sector medians for each support category;
(b) issuing confidential quarterly peer comparison reports to all Tier 1 providers, modelled on the ATO’s peer comparison approach (as documented in APSC, State of the Service Report 2024-25);
(c) streamlining registration and compliance for providers demonstrating below- median overheads; and

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(d) delivering benchmarking data at natural decision points - price lodgement, registration renewal, and following Award or Price Limit changes. Rationale: The ATO’s real-time nudge messaging program, evaluated through randomised control trial, found taxpayers who received a peer comparison prompt were 2.5 times more likely to review their return and 3 times more likely to adjust their data. In 2023-24 alone, 712,000 prompts protected an estimated $92.6 million in revenue without a single audit or penalty (APSC, State of the Service Report 2024-25). The dual-cap mechanism provides the structural consequence that makes the behavioural tools sustainable: nudge plus architecture, not nudge alone.

Recommendation 4: Independent Review of 2:1 Support Pricing

The Committee should recommend that the Government commission an independent review of pricing methodologies for participants requiring support ratios above 1:1, to determine:

(a) whether current pricing accurately reflects the marginal cost of additional support workers;
(b) whether pricing structures unintentionally overstate costs by proportionally doubling fixed overhead components (rent, IT, executive salaries) that do not increase with additional support workers;
(c) whether a standardised per-FTE overhead allocation methodology would produce materially different cost outcomes; and
(d) what savings could be achieved through more accurate overhead allocation without reducing participant supports or support worker remuneration. Rationale: When a participant moves from 1:1 to 2:1 support, direct labour costs double. Organisational overheads do not. Non-service level staff wages represent 37.5 per cent of total overheads. If fixed costs are allocated proportionately rather than on a per-FTE basis, participants requiring 2:1 support absorb a disproportionate share of costs that have not actually increased. For one participant alone, correcting this yields a saving of $156,435 per year - same hours, same two workers, same participant.

Recommendation 5: Standardised Annual Overhead Benchmarking

The Committee should recommend that the NDIA establish a standardised annual overhead benchmarking framework under which:

(a) all Tier 1 providers are required to report overhead costs using a standardised per-FTE allocation methodology across all services delivered by the entity;
(b) overhead reports clearly distinguish between fixed overheads (which should not increase proportionately with support ratios) and variable overheads;
(c) benchmarking data is published annually on an aggregate basis, enabling comparison across support categories and provider cohorts; and

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(d) the NDIA publishes the sector median price alongside the Price Limit for each support line item. Rationale: The last publicly available benchmarking was published in May 2022 and the NDIA has confirmed it did not run the 2022-23 survey. The absence of updated benchmarking is inconsistent with the NDIA’s role as market steward and undermines the evidence base for the sustainability measures proposed in this Bill.

Recommendation 6: Review of Market Design in Thin Markets (section 73EA)

The Committee should recommend that the Government undertake a targeted review of market design and competitive dynamics in NDIS support categories characterised by high switching costs, administered pricing and limited provider competition, including:

(a) assessment of the extent to which participant choice is creating effective price competition in complex support markets;
(b) examination of alternative market designs, including competition-for-the- market models, hybrid commissioning arrangements and preferred provider panels; and
(c) recommendations regarding which support categories would benefit from structured procurement or commissioning approaches under section 73EA of the Bill.

Recommendation 7: Sequencing of Sustainability Measures (sections 34A and 45C)

The Committee should recommend that the Bill be amended to require that sustainability measures addressing provider-side efficiency and market structure be implemented prior to, or concurrently with, any further reductions in participant funding under sections 34A or 45C. Specifically, before significant reductions are implemented, the NDIA should be required to demonstrate that it has:

(a) examined whether the cost of delivering the relevant supports is reasonable having regard to market conditions, pricing structures and provider efficiency;
(b) implemented benchmarking and transparency mechanisms of the kind described in Recommendations 1-5; and
(c) allowed sufficient time for those mechanisms to produce observable changes in provider pricing behaviour.

Recommendation 8: Annual Transparency Reporting (section 118(1)(baa))

The Committee should recommend that the NDIA be required to publish annually:

(a) updated data on the proportion of providers in each pricing tier;
(b) benchmarking data on provider overhead structures in high-cost support environments;

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(c) analysis of cost drivers in support categories where expenditure growth exceeds participant growth;
(d) progress against market efficiency objectives; and
(e) the sector median price alongside the Price Limit for each support line item in the NDIS pricing schedule.

Conclusion I support the objective of securing the NDIS for future generations. However, long-term sustainability will not be achieved solely through tighter plans, reassessments or participant funding controls.

This submission proposes a transparency-linked dual-cap pricing mechanism, grounded in the UK Behavioural Insights Team’s EAST framework, that would generate self-sustaining benchmarking data, create direct financial incentives for provider transparency, deploy proven behavioural tools, and address the structural drivers of cost growth - without reducing participant supports or support worker wages.

Before Parliament asks participants and families to absorb further reductions, it should satisfy itself that underlying market issues have been thoroughly examined and that proven mechanisms for driving provider-side efficiency have been deployed.

The NDIS will be secured for future generations not simply by spending less, but by ensuring that every dollar spent delivers the greatest possible value for participants, taxpayers and future generations.

Availability to Give Evidence I am willing to appear before the Committee to give oral evidence in support of this submission if that would assist the inquiry.

I am also willing to provide supporting documentation, including evidence of the proposed funding reductions referred to in this submission, relevant clinical and allied health evidence regarding my son’s support needs, and other material that may assist the Committee in understanding the practical implications of the issues raised.

Related Submission This submission should be read in conjunction with my separate submission addressing participant safety, functional capacity and duty of care, which addresses complementary concerns arising from Schedule 1 of the Bill.

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