Who I work with
Allied Health sits inside almost every part of the health and disability system, and the organisations delivering it look nothing like each other.
Organisations like yours
Pick the role closest to yours. An organisation can sit under more than one, and these are the ones I work with most, not the only ones.
Providers
Organisations that deliver the service. What separates them commercially is who owns them, because ownership decides who signs, how decisions get made and what a good outcome is allowed to look like.
Commissioners and funders
Organisations that buy Allied Health for somebody else. What they need from me is a current, provider-side picture of how the market actually responds to the thing they are designing.
One step back from delivery
Organisations that serve providers rather than employing clinicians. They engage me as a subject matter expert for their own clients, members or audience.
Who sets the price
Ordered from the most policy exposure to the most pricing freedom. Pick a payer family to see what sits in it.
Commonwealth entitlement
- NDIS
- The Commonwealth, unilaterally
- Aged Care and Support at HomeSupport at Home and residential Aged Care
- The Commonwealth, then the registered provider
- Medicare
- The Commonwealth, with a gap you set
- DVA
- The Commonwealth, unilaterally
Block and grant funded
- Commissioned and grant programsState programs, PHN commissioning, CHSP and philanthropic grants
- Negotiated at contract, then fixed
Insurance and injury schemes
- Workers compensation and CTP
- The scheme regulator, or you where fees are unprescribed
- Private health insurance
- You, against a rebate you do not control
Private and commercial
- Private fees and commercial work
- You
Funding stream matters less than it used to
Almost every organisation I work with is paid from more than one place, and the questions worth asking cut across all of them. A private practice billing NDIS also has Medicare, private fees and often DVA. A community health service runs state funding alongside Commonwealth programs. The interesting problems live at the joins.
So the first thing I do is usually a payer mix concentration analysis. Revenue split by payer family, then by individual stream, with the largest single stream expressed as a share of the total. Any one stream above half of revenue makes you a policy taker and your margin is set in Canberra. Above three quarters, a single pricing decision by one payer stops being a bad quarter and becomes an existential event.
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
Not sure where you sit?
Most organisations sit across two or three of these and the answer changes depending on which one is growing. Book a discovery call to work it through. You leave with an honest read on where things stand and a clear recommendation.