Government targets ‘over-servicing’ by physiotherapists

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Government targets aged care ‘over-servicing’ by physiotherapists

The federal government believes aged care homes are wasting money on allied health services such as physiotherapists, which will no longer be directly funded under new rules.

A letter from Aged Care Services Minister Richard Colbeck, seen by The Sydney Morning Herald and The Age, says the new model to be introduced in October will remove incentives to deliver treatments “that are not necessarily the most clinically appropriate”.

About 63 per cent of older people in residential aged care receive physiotherapy to manage pain and more than half see their physiotherapist four times a week, according to the Australian Physiotherapy Association.

Under the new model, it will be up to aged care providers to decide if these treatments are necessary.

Some homes are considering transitioning to group yoga and tai chi classes run by “lifestyle officers” employed more cheaply than physiotherapists, as provider peak bodies push the federal government to provide certainty in their funding arrangements.

Paul Sadler, the chief executive of non-profits’ peak body Aged and Community Services Australia (ACSA), said providers were having “tricky” conversations with allied health contractors amid uncertainty about their budgets.

While he agreed the current system led to “over-servicing”, he said removing funding tied specifically to allied health risked swinging “from one extreme to the other on the pendulum”.

“We do need a proper funding model for allied health,” Mr Sadler said.

The Australian Aged Care Collaboration, representing six aged care provider peak bodies including ACSA, is calling on the government to announce details of the new funding model so providers can plan with certainty.

A Health Department official told an industry webinar on Friday that the release of the information was “a matter for government” and that data from providers would be analysed to make sure they were still providing access to allied health services.

Alwyn Blayse, a physiotherapist who founded a campaign called the Death of Allied Health, is calling for dedicated allied health funding of at least 20 minutes a day per resident.

“They don’t spend a cent they don’t have to,” Mr Blayse, chief executive of contractor AAC Allied Aged Care, said.

Professor Kathy Eagar, the director of the University of Wollongong’s Australian Health Services Research Institute, said providers should be forced to provide 22 minutes a day of allied health, up from the current average of eight minutes.

My Blayse said without funding tied to specific services, providers could say they had not been able to find a provider.

The Health Department said in a statement the new model “enables appropriate treatment, including allied health, to deliver the care that is best aligned to residents’ needs and goals in accordance with the resident’s care plan”.

“This removes the risk of perverse incentives to deliver treatments that are not clinically appropriate in order to maximise funding, such as providing massages for residents with paper-thin skin,” it said.

The current rules only allow physiotherapists to give massages and not exercise physiotherapy, which evidence shows can reduce pain.

The Aged Care Royal Commission heard physiotherapy could reduce the risk of falls among elderly residents by 55 per cent and recommended changes in its March 2021 final report “to ensure residential aged care includes a level of allied health care appropriate to each person’s needs”.

Research by accountancy firm StewartBrown shows aged care providers currently spend about $830 million a year on allied health such as physiotherapists, occupational therapists and podiatrists, along with lifestyle officers and physio assistants.

The federal government allocated $27.9 million for allied health in aged care in its COVID-19 package, equal to two seconds a resident per day over four years.

Labor has not announced what changes it will make to the aged care system if it wins the election, due by late May.

Labor’s aged care spokeswoman, Clare O’Neil, said access to allied health care was “crucial to the health and wellbeing of aged care residents.”

“There is a wealth of evidence that tells us just how important these interventions are in maintaining and enhancing a resident’s cognitive functions, dexterity and mobility,” she said.

She said the government’s reform of the sector had been “sluggish and opaque”.

www.smh.com.au/politics/federal/government-targets-aged-care-over-servicing-by-physiotherapists-20220318-p5a5wy.html

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