Funding environments
Workers compensation and CTP
Ten workers compensation schemes and eight motor accident schemes, each with its own fee schedule, approval process and reporting obligation.
CTP and workers compensation are not the same decision
Workers compensation fees are prescribed by the scheme regulator or the insurer in most jurisdictions, and a number of schemes set no rate at all. Motor accident works differently across the board: every CTP scheme in the country leaves Allied Health fees unprescribed, which means a practice can bill its own rate subject to insurer approval before treatment begins.
That distinction is the commercially important one and it is easy to miss, because the schemes are usually described as a single category. The revenue here is decided by which scheme you are billing rather than by what you deliver.
There are eighteen schemes and each one sets its own rules. Working across a border is the trap that comes up most often, because a practice treating in two states is operating under two sets of them at once.
What gets brought to me
Is this work worth taking at all
The rate is only half the question. Approval gating, reporting obligations and payment timing decide whether the work clears its own cost once the administration is counted.
We operate across a border and nothing matches
Different fee schedules, different approval processes, different reporting. The same applies to psychosocial hazard obligations, deemed worker provisions and payroll tax, none of which are answered nationally.
The reports are where the money is and we treat them as overhead
In occupational rehabilitation the hourly rate is much the same as treatment. The margin sits in the block-priced reports and the outcome payments.
Cash flow is the constraint rather than demand
This is the slowest paying family in the sector. A practice diversifying into it without modelling the working capital finds out the hard way.
What I am usually asked for
- Whether to enter injury scheme work, and in which jurisdictions first
- Rate and margin analysis against a specific scheme's fee position
- Cross-border exposure, including deemed worker and payroll tax questions
- Occupational rehabilitation service design, including reports and outcome payments
- Cash flow modelling for an approval-gated, slow-paying stream
- Diversification sequencing for a practice weighted toward one funder
Tools and guides
Allied Health Consultation Tracker
Open, upcoming and recently closed consultations on how Allied Health is funded, regulated, paid and employed, with the date each one closes.
Allied Health Margin Calculator
Model what a clinician costs fully loaded, then test it against any scheme's rate to see whether the work clears once utilisation is realistic.
Who I work with
Where injury schemes sit against the other seven funding environments, and why payer spread is what makes a practice resilient.
Advice from someone who has run the business
Clinicians at the provider I co-founded
Annual revenue at that business
Allied Health providers I have worked with
Independent advice, no clinical services
Deciding whether to take scheme work on?
The answer usually turns on which jurisdiction you are in rather than on the clinical work. A discovery call will tell you whether it fits.