Planning and Decision Making for High Cost, High Liability Supports within an Insurance...

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