NDIS Pricing Reforms Won’t Fix Outcomes Without Capability
There is currently significant focus on pricing reform, funding rates, and budget adjustments across the disability sector. These conversations matter. Funding shapes what services can afford to deliver. But pricing alone does not guarantee better outcomes. Evidence, practice experience, and lived reality across services continue to point to the same conclusion: worker capability is the strongest predictor of participant outcomes, including choice, autonomy, safety, dignity, and quality of life. Simply put, money follows practice — not the other way around.
Why pricing reform feels like the answer
The disability support workforce in Australia is facing a well-documented shortfall. According to the 2024 National Disability Services Workforce Census, over 67,000 Disability Support Employees were represented, yet workforce shortages remain a core challenge for the sector.
Other research predicts the workforce required will need to expand by at least 31% heading into 2026, equating to tens of thousands more workers to meet participant needs.
A Survey in August 2025 by the Health Services Union (HSU) of current workers, also reflect this pressure with 72% of Disability Support Workers report the workforce is not large or stable enough to meet current and future needs, and more than 62% experience frequent burnout.
On the financial side, many providers are operating under sustained strain. Industry data indicate 34% of organisations within the sector self-reported operating at a loss in the 2023-24 financial year, with cost pressures from wages, insurance and compliance cited as key contributors.
Provider Financial Position
In addition, recent reporting has noted a rise in insolvencies among disability and social assistance providers, highlighting the risk that tight pricing and cost structures are undermining provider sustainability.
These statistics explain why pricing reform has become central to sector discussions — it intersects with workforce supply, service quality, and organisational viability. In this context, it’s tempting to believe that:
Higher rates will automatically lead to better supports
More funding will fix quality issues
Improved budgets will translate into better lives
But history shows us that resourcing without capability rarely delivers the change we expect.
What the Evidence keeps telling us
There is robust literature showing that workforce capability, not just workforce size, predicts quality of support outcomes. Research on the broader care workforce (including disability and aged care settings) points to chronic shortages, high attrition and the importance of education and training for safety and quality of care.
While explicitly disability-specific longitudinal outcome studies are still emerging, broader workforce studies support the relationship between capability, reflective practice, mentoring and improved care delivery. The NDIS Workforce Capability Framework from the NDIS Quality & Safeguards Commission articulates the knowledge, skills and behaviours linked to safe, effective and rights-based support — including critical thinking, ethical judgement, and reflective practice.
Evidence from related care fields also shows that structured reflective practice improves professionals’ ability to integrate knowledge and apply it in complex real-world contexts. For example, longitudinal studies in other health and work-based learning environments show structured reflection enhances the sophistication of practice over time, which aligns with findings across allied and care workforces.
While specific “disability outcomes = capability” RCTs are limited, this broader body of research validates the underlying mechanism: structured guidance, mentoring and real-time reflection consistently improve practice quality and worker judgement.
This pattern holds true regardless of funding levels. Where practice is weak, additional funding often gets absorbed by:
Higher staffing ratios without improved quality
Increased paperwork without better decision-making
Risk-averse systems that restrict autonomy rather than support it
In other words, money amplifies existing practice — good or bad.
Capability is not the same as training
One of the most persistent misunderstandings in the sector is equating training with capability.
Training tells people what to do. Capability is knowing how to apply it in real situations, under pressure, with real people.
Support workers and leaders are required to:
Interpret behaviour, sometimes with or without a Behaviour Support Plan
Balance safety with autonomy, or dignity with duty of care
Make judgement calls in complex, unpredictable moments
Communicate consistently and calmly
Uphold human rights in everyday decisions
These are not checklist skills. They are judgement-based capabilities.
And they are not built through one-off modules or compliance-focused learning.
Why pricing reform without capability stalls
The claim that “when pricing reform is the primary focus, capability tends to be overlooked” can be supported by sector surveys and expert analysis showing that pricing changes without systemic support for workforce development correlates with stalled quality improvements.
Reports from peak bodies and independent analysis indicate that pricing reviews historically have prioritised cost containment over capability infrastructure (e.g. systems for ongoing professional support and supervision). Specific submissions to policy consultations and workforce reviews highlight this trend, arguing the need for balanced attention to both funding and workforce capability.
In public policy discussions — such as the NDIS National Workforce Plan and parliamentary inquiries — stakeholders repeatedly emphasise that without investment in workforce readiness and capability, pricing reforms alone will not deliver the service quality improvements participants and families expect. When reform focuses primarily on pricing, three things tend to happen:
1. Systems Expand Faster than Skills
More funding increases activity, but not necessarily competence. Workers are asked to do more without being better supported to think, decide, and adapt.
2. Compliance Overtakes Quality
Increased scrutiny often leads to more process, not better practice. Workers become risk-averse, documentation-heavy, and less confident in exercising judgement.
3. Outcomes Plateau
Despite higher investment, organisations see the same issues repeating:
Inconsistent practice
Preventable incidents
Workforce burnout
Limited progress on genuine choice and autonomy
Sound familiar? If you work in the sector than you no doubt have experienced at least one, if not all of these barriers before.
The problem is not effort or intent. The problem is capability depth.
What actually drives better outcomes
If we want reform to translate into better lives, the focus must shift from inputs to mechanisms. Better outcomes come from:
Skilled, confident, and supported workers
Leaders who model rights-based, evidence-informed practice
Systems that embed capability, not just compliance
Structured reflection and mentoring, not reactive debriefs
Practice support that turns experience into learning
Capability grows when workers and leaders are supported to:
Think clearly under pressure
Reflect on decisions, not just incidents
Apply principles consistently in real contexts
Build confidence through guided practice, not trial and error
This is what turns Funding, and Funding Reforms, into Impact.
An opportunity, not a criticism
Pricing reform is not the problem. It is an opportunity.
But without deliberate investment in workforce capability, pricing reform risks becoming another cycle of expectation without delivery.
If the sector truly wants reform to result in Safer Services, Stronger supports, and Better Lives, then capability must be treated as core infrastructure, not an optional add-on.
Because outcomes don’t improve when money changes hands, they improve when practice changes.
About Aquaviva Academy
At Aquaviva Academy, we focus on strengthening workforce capability through practical, evidence-informed learning, reflective practice, and real-world skill development — supporting workers and leaders to translate intention into impact.
References
Note on evidence: Disability-specific longitudinal and experimental studies directly linking workforce capability interventions to participant outcomes are still emerging. However, the mechanisms discussed in this article — reflective practice, mentoring, supervision, and judgement-based capability — are consistently supported across disability, aged care, health, and professional education literatures as drivers of improved practice quality and safety.
Australian Government Department of Health. (2021). NDIS national workforce plan 2021–2025. https://www.health.gov.au/resources/publications/ndis-national-workforce-plan-2021-2025
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Carey, G., Malbon, E., Olney, S., & Reeders, D. (2018). The personalisation agenda: The case of the Australian National Disability Insurance Scheme. International Review of Sociology, 28(1), 20–34. https://doi.org/10.1080/03906701.2018.1424362
Health Services Union. (2025). Disability support worker survey: Workforce sustainability, burnout and retention (Unpublished union survey). Health Services Union, Australia.
King, D., Mavromaras, K., Wei, Z., He, B., Healy, J., Macaitis, K., Moskos, M., Smith, L., & Zhang, W. (2012). The aged care workforce, 2012. Australian Government Department of Health and Ageing.
https://www.health.gov.auNational Disability Services. (2024). NDS workforce census report 2024. https://www.nds.org.au/resources/nds-workforce-census-report-2024
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https://www.pc.gov.au/inquiries/completed/ndis-costsProductivity Commission. (2023). Review of the National Disability Insurance Scheme. https://www.pc.gov.au/inquiries/completed/ndis-review
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https://doi.org/10.3109/13668250.2014.884729United Nations. (2006). Convention on the Rights of Persons with Disabilities.
https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.htmlVictorian Auditor-General’s Office. (2023). Supporting the NDIS market.
https://www.audit.vic.gov.au/report/supporting-ndis-market