Current issues in pricing across aged care and disability in Australia
Author Bridget Browne
Abstract
The Australian disability, aged care, and health sectors are undergoing significant transformations due to demographic shifts, policy changes, and increasing demand for services. Commonwealth Government spending on these areas is significant and growing – in FY25 expenditure on the National Disability Insurance Scheme, aged care and the Medical Benefits Scheme was expected to be $48.5 billion, $37.2 billion and $32.7 billion respectively, forming 3 of the top 5 programs by expense (Commonwealth of Australia, 2025, p. 119). Effective pricing and scheme design are crucial to ensuring the sustainability and accessibility of these services. This paper considers recent reviews, recommendations and reforms regarding pricing across aged care and disability in Australia, including the transition of aged care pricing responsibilities to the Independent Health and Aged Care Pricing Authority (IHACPA), the new arrangements for in-home aged care and the report of the Independent Pricing Committee established by the National Disability Insurance Agency (NDIA). It explores these pricing frameworks and associated policy choices and highlights similarities, differences, overlaps and potential impacts and opportunities.
Is Workers' Compensation Fit for the Future?
Author Steve Somogyi
Abstract
The combined statistics published by Safe Work Australia for the nine years from 2013-14 to 2022-23 shows increasing claims frequency per million hours worked, increasing median time lost per injury resulting in a significant increase in median claim cost per injury. This reflects a change in the mix of occupations as the Australian economy matures from goods focussed industries to service industries, a change in the working population with an older workforce including a higher proportion of females and more part time work, and a significant change in compensation claim types especially the fast rise of psychosocial claims. These trends are forecast to continue with Oxford Economics 4 , in a paper prepared for Jobs & Skills Australia, projecting continuing movement away from goods industry occupations to service industry occupations to 2050 and beyond, thereby increasing the exposure to psychosocial claim types and reducing exposure to physical injury claim types. The Intergenerational Report (IGR) 1 published by Treasury in 2023 projects a continuing ageing of the population and by implication of the working population.
My projections, using these population trends but with static claims incidence and cost of claims continuing to outpace wages by 1.5% per annum, show that the cost of workers compensation claims is likely to outpace growth of Australia’s Gross Domestic Product by around 3% per annum. Even more if we fail to stem the fast growth of psychosocial harm. We need to consider some new strategies to ameliorate this outcome to enable workers compensation schemes to best serve Australian workers and enterprises, perhaps anticipating the problem by adopting more effective prevention strategies and more intensive efforts in returning workers to the workplace.
Modelling mortality rates for catastrophically injured individuals in Australian and New Zealand injury and disability schemes
Authors Aaron Cutter, Angela Poon, Roel Verbelen, Mayank Jain, Vinit Desai
Abstract
Background: It is well established that mortality rates for catastrophically injured participants in injury and disability schemes are higher than those of the general population. However, the extent of this excess mortality within Australian and New Zealand schemes has not previously been quantified. Finity coordinated a collaboration between nine injury and disability schemes across Australia and New Zealand to conduct the first comprehensive trans-Tasman study of mortality for catastrophically injured participants. By pooling data across schemes, this collaboration enabled a larger population to be studied, facilitating deeper and more reliable analysis of mortality experience.
Methods: To develop life tables for impaired lives associated with Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) cohorts, we modelled observed mortality rates using a Poisson Generalised Additive Model (GAM). Population mortality rates by age, gender, year and jurisdiction were incorporated as offsets, allowing the model to estimate mortality relative to the general population on the log scale across covariates. The resulting fitted values can be interpreted as covariate-specific Standardised Mortality Ratios (SMRs).
Results: The study quantified mortality outcomes for catastrophically injured individuals by producing SMRs relative to the general population for TBI and SCI cohorts across Australia and New Zealand. The modelling framework revealed substantial variation in excess mortality by age at injury, gender, injury severity, and duration since injury. Consistent with international research, we also found that mortality improvements observed in the general population have not been mirrored in these cohorts. The outputs are SMR tables that can be directly applied in actuarial valuations and premium or levy assessments, providing a robust and context-specific basis for modelling mortality of catastrophically injured participants in Australia and New Zealand.
The Long(itudinal) Road to Recovery – Using Survey Data to Understand Broader Outcomes and Vulnerabilities of Injured Workers
Author Hugh Miller and Laura Dixie
Abstract
While the importance of broader biopsychosocial factors in understanding injury schemes has long been recognised, there remains significant challenges in understanding the broader life context of people in injury schemes, as well as how they interact with other health and income supports. We review the literature on broader and post-injury outcomes related to accident compensation schemes. We then use Australia's leading longitudinal research study, the Household, Income and Labour Dynamics in Australia (HILDA) survey to build the understanding of pathways and outcomes for people receiving accident compensation support. HILDA provide annual updates on the life circumstances of a cohort representative of the Australia population for over 20 years.
This enables us to examine:
- Health, income and other socioeconomic characteristics before and after accident compensation receipt
- Income pathways (including changes of employment and welfare receipt) for people post-injury
- Health pathways (including both mental and physical health ratings as well as quality of life ratings) for people post-injury.
The use of both broader wellbeing and quality of life measures combined with examination of both immediate outcomes and longer-term pathways makes this study unique. We find:
- The cohort examined largely have short-duration compensation claims with payments only received in one year. However, significant negative outcomes are visible for those with claims lasting longer (3 or more years), particularly on wages, employment status and health.
- Many short-term claims see wages recover quickly and employment remains reasonably high for the first 3 years post injury. Household income remains steady, even for those with longer-duration claims.
- General health outcomes tend to be mirrored by changes in mental health (although the self-rated nature may contribute to this). Injuries leading to compensation tend to be significant life events – impacts are similar to other major life events.
- Care responsibilities increase for partners of claimants, and there is no evidence of partners picking up additional employment.
