Joint Standing Committee on the National Disability Insurance Scheme
PO Box 6100
Parliament House
Canberra ACT 2600
Melbourne, 20 February 2024
Submission to the inquiry on The NDIS participant experience in rural, regional and remote Australia
Our submission addresses point a. (in particular plan review) and point b. (the effectiveness of the NDIA outlined in the terms of reference. Our submission highlights the two following points detailed hereafter:
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NDIS participants in rural areas were more likely to substitute mental health services from their GP to NDIS funded services.
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NDIS plan reviews in rural area need to be carefully undertaken given the potential detrimental impact of reviewing supports for people with disability
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The interaction of NDIS and Medicare in rural areas: substitution from GP to NDIS funded mental health services
Ma (2024) examined the interplay between the NDIS and subsidized healthcare in Australia by shedding light on whether the NDIS:
i) increased healthcare use by breaking barriers to healthcare access ii) lowered healthcare use by improving people’s conditions (by non-medical means) iii) lowered Medicare funded healthcare by using similar NDIS-funded services (eg. some services delivered by allied health professionals and psychologists)
Her work suggests a potential substitution from Medicare to NDIS funded services with Medicare funded mental health services decreasing after NDIS enrolment. She finds a reduction in services provided by psychologists and a reduction in mental health services provided by allied health professionals after NDIS enrolment in major cities. For regional and remote areas, mental health services provided by GP decrease which suggests a potential a substitution from Medicare to NDIS funded services. There is no such effect for psychologists or allied health professionals providing mental health services which are traditionally less prevalent in rural areas.
While lower use of mental health services could indicate better mental health, the prescriptions related to mental healthcare do not change and therefore the experience of NDIS participants in rural areas is likely associated with a shift from Medicare to NDIS
funded services which is likely to be associated with lower out of pocket use for mental health services given the absence of out of pocket costs for NDIS funded services.
- Reassessments can lead to increased stress Our work (Badji, Kavanagh and Petrie, 2023) suggests that when people with disability feel that their support is threatened, it can have detrimental effects on their mental health (See The Conversation article, 2023). If NDIS reviews are seen as a threat to the support of NDIS participants, then these reviews could be particularly stressful and given the less generous availability of mental health services in rural areas, there could be poor outcomes as a result of the reviews.
Dr Samia Badji Dr Bernice Hua Ma
Research Fellow Former PhD student
Centre for Health Economics Centre for Health Economics
Monash Business School Monash Business School
Monash University Monash University
Level 5, Building H, Caulfield Campus Level 5, Building H, Caulfield Campus
900 Dandenong Road 900 Dandenong Road
Caulfield East, VIC 3145 Caulfield East, VIC 3145
Associate Professor Gang Chen Professor Dennis Petrie
Centre for Health Economics Centre for Health Economics
Monash Business School Monash Business School
Monash University Monash University
Level 5, Building H, Caulfield Campus Level 5, Building H, Caulfield Campus
900 Dandenong Road 900 Dandenong Road
Caulfield East, VIC 3145 Caulfield East, VIC 3145
References
Ma, Bernice Hua (2024). Economics of services and support to people with disabilities. [Unpublished doctoral dissertation]. Monash University. ttps://doi.org/10.26180/25149494.v1
Badji, S., Kavanagh, A., & Petrie, D. (2023). The impact of Disability Insurance reassessment on healthcare use. Health Economics, 32(7), 1581–
- https://doi.org/10.1002/hec.4680 The Conversation NDIS cost scrutiny is intensifying again – the past shows this can harm health and wellbeing for people with disability Samia Badji, Dennis Petrie & Anne Kavanagh 1/05/23