planning and decision making for high cost, high liability supports within an insurance...
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Sally Babington, Manager, National Serious Injury service, Accident Compensation Corporation (ACC) New Zealand delivered this presentation at the 2013 National Disability Summit in Australia. The annual conference brings together healthcare industry professionals to discuss the future direction of disability policy reform. For more information, please visit the conference website: www.healthcareconferences.com.au/nationaldisabilitysummitTRANSCRIPT
Sally Babington
Accident Compensation
Corporation of NZ
NZ’s scheme
•ACC been running no-fault insurance scheme since 1974 –Covers all types of injury
–Wherever they occur
NSIS
•Set up in 2008
•2-part strategy –Client outcomes
–Sustainable costs
2003 2004 2005 2006 2007 2008 2009 2010
Cost per claim
Benefits of focusing on client outcomes
Why outcomes?
Internationally the common
characteristics of people with
disabilities
Social isolation
Financial hardship
Loss of valued roles
What outcomes?
•Participation in everyday life –Home
–Work
–Leisure
–Community
Clients achieving their outcomes
•Planning –Person-centred
•Funding supports & service –To achieve client outcomes
•Monitoring –Outcomes as measured by goal achievement
1. Planning
• Person-centred
• Outcome-directed
1. Home & living
2. Work & education
3. Leisure/recreation
4. Community
Planning in action
Where will these
supports come from ?
What supports
are needed ?
Community Employer
Family ACC
Client Other funders
School
1. Home/living
2. Work/education
3. Leisure /recreation
4. Community access
Participatory
goals
Treatment
Rehabilitation
2. Support
•Assessment
•ACC-funded support & services
3. Monitoring
Individual’s plan
Individual’s objectives
Potential changes to supports & services
Performance reporting
Supporting evidence (standardised measures)
Outcome against objective 3 = Achieved beyond expectation
2 = Achieved
1 = Partially achieved
0 = Not achieved
Developed with assistance from Dr Maree Dyson
3. Monitoring
Individual’s plan
Participation & well-being goals
Potential changes to supports & services
Performance reporting
Supporting evidence (standardised measures)
Stability of needs & circumstances 2 = Increased participation
1 = Stable needs & circumstances
0 = Unstable needs & circumstances
Developed with assistance from Dr Maree Dyson
Results
•71% goal achievement
•23% in paid work
•83% client satisfaction
Results
•Attendant care costs stabilised
2003 2004 2005 2006 2007 2008 2009 2010
Cost per claim
Results
•Attendant care costs stabilised
•$1.3 billion long-term savings over 3 years
Still to do…
•Procurement –Purchasing for outcomes
•Client self-management –Pilot starting mid-2013
Summary
•Outcomes part of NSIS design blueprint
•Key to stabilising costs
•Not finished – still have work to do
What can you expect in the future?
There will be changes
•People with disabilities
•Premium payers
•Suppliers
•Carers
Conclusion
•Relentless focus on client outcomes
•Still have work to do