SIRA bulletin - Issue 32
New transparent reporting on healthcare costs
A new dashboard on healthcare costs and outcomes in the workers compensation and CTP schemes has been published on the SIRA website.
With healthcare costs exceeding $1 billion each year, the dashboard provides a transparent account of utilisation, costs, and performance trends.
The dashboard shows that following a period of rising healthcare costs at 12 per cent each year since 2016, healthcare costs in workers compensation grew only by 0.75 per cent in 2019/20, partly as a result of fewer surgeries during the reporting period.
Allied health services continue to be the fastest-growing healthcare service in workers compensation. Expenditure on allied health has increased by 10 per cent in the year to 2019/20.
The new dashboard forms part of SIRA’s response to the Healthcare review, which has been focused on ensuring that every dollar spent on healthcare delivers the right healthcare services, at the right time, so injured people recover as well as possible. SIRA will continue to publish updated healthcare dashboards each quarter.
Read more about the findings in the workers compensation and CTP schemes and view the dashboard on the SIRA website.
Framework to measure value-based care
To progress the implementation of value-based care in the workers compensation and CTP schemes, SIRA has published a Value-based healthcare outcomes framework.
The framework provides a series of metrics for monitoring and reporting healthcare outcomes and costs in the schemes. The need for improved data collection and reporting was a key finding from SIRA’s Healthcare review and stakeholder feedback.
SIRA will work with stakeholders to co-design the implementation of the framework. Once implemented, SIRA will be able to measure the value of healthcare – through the health and quality of life outcomes that are achieved - and report comparatively on insurer performance.
You can view the framework on the SIRA website.
Updated COVID-19 advice
SIRA has updated its COVID-19 resources to help injured people, employers, and service providers during the current outbreak.
Some important points to note:
- Insurers are to continue to report COVID-19 workers compensation claims to SIRA on a weekly basis.
- Workers in prescribed employment who contract COVID-19 are automatically presumed to have contracted the virus in the course of their employment and are entitled to workers compensation.
- Telehealth services remain available without insurer pre-approval for nominated treating doctors, medical specialists (within 3 months from the date of injury), and some allied health services.
- Treating physiotherapists and psychologists can issue the second and subsequent certificate of capacity/fitness for injuries or illness within their area of expertise. The first certificate of capacity/fitness must be issued by the nominated treating doctor.
- SIRA programs that offer financial incentives to support recovery at work continue to be available in the workers compensation or CTP schemes.
- Free mental health resources can be accessed through the COVID-19 hub for injured workers and road users or the COVID-19 hub for employers.
For the most up-to-date COVID-19 advice, please refer to the SIRA COVID-19 webpage.
You can also view the number of COVID-19-related workers compensation claims and notifications through the Open Data Portal.
Medico-legal examinations during COVID-19
In response to the current COVID-19 restrictions, SIRA has updated the guidance for medico-legal examinations.
When scheduling a medico-legal examination, the insurer/referrer must consider whether attendance at an appointment is permitted by the public health orders in force at the time.
The current restrictions mean that:
- no face-to-face medico-legal examinations are to proceed in the Greater Sydney region, including for any person whose place of residence or usual place of work is in Greater Sydney
- where a face-to-face medico-legal examination is able to be arranged, (ie not within the Greater Sydney region), the injured person will be required to wear a fitted face covering at all times.
You can read the updated guidance on the SIRA website.
Closing today: Review of the authorised health practitioner framework for the CTP scheme
Public consultation on the post-implementation review of the authorised health practitioner framework in the NSW CTP scheme closes today, Friday 6 August 2021 at 5.00pm.
Time is running out to have your say on:
- the appropriateness and effectiveness of the framework
- associated administrative processes
- the customer experience of injured persons
- the early and just resolution of disputes
- training or support requirements for practitioners, and
- how SIRA measures the framework’s overall effectiveness.
Scheme participants and stakeholders are invited to submit a response via the SIRA website.
Your feedback will inform potential improvements to help deliver a better experience for the injured person and encourage the early resolution of motor accident claims.
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