Navigating sector uncertainty and what OTs need to know right now
The disability sector continues to shift rapidly, with new reports, pricing discussions and workforce pressures influencing how providers operate. For many OTs, the mix of policy noise, business demands and day-to-day practice pressures can feel overwhelming. This week’s developments highlight the importance of staying informed, planning deliberately and understanding the broader context shaping service delivery.

Life and business behind the scenes

Many OTs are juggling work demands alongside family responsibilities, volunteering commitments and the realities of running a business. The pressures of the past year have left many clinicians stretched thin. For some, even basic self-care and community involvement have been pushed aside in favour of immediate business demands. This is a reality across the sector, not a personal failing.

It is a reminder that capacity fluctuates over time and that professional expectations must be balanced against what providers can realistically sustain. As workloads intensify and uncertainty continues, reassessing commitments has become essential. Many clinicians are now reconsidering their volunteer roles, workload distribution and business structures to prevent burnout and protect long-term career sustainability.

New analysis on physiotherapy pricing and what it signals for all allied health

The Australian Physiotherapy Association recently released an independent analysis of the 2024–25 Annual Pricing Review. Although focused on physiotherapy, the findings mirror concerns shared across allied health.

Three major issues were identified...
Session durations were modelled inaccurately: The APR assumed longer average session times than what occurs in practice. This inflated the perceived hourly rate and contributed to lower price caps. The review found typical private consults were closer to 30 minutes, not 45.

Data sources were limited and unrepresentative: The APR relied heavily on publicly listed prices, selective Medicare data and a single private health insurer. Most physiotherapy clinics do not publicly publish fees, and the data used did not reflect the complexity, load or structure of disability work.

NDIS-specific complexity was not sufficiently captured: Productivity expectations, non-billable time, compliance requirements and travel obligations differ significantly between NDIS and private practice. The model did not account for this, underestimating the cost of delivering disability-specific services.

Independent benchmarking estimated a realistic 75th percentile hourly rate closer to $215–$260 per hour, considerably higher than the APR’s estimate of $150. While this report focuses on physio, its themes are highly relevant to OTs. Many of the same pressures exist across disciplines, including heavy administrative loads, higher complexity and significant non-billable work. Importantly, this is not a moment for allied health professions to compete or criticise one another’s peak bodies. Sector sustainability will only be strengthened through unified advocacy, shared messaging and coordinated responses to policy change.

What the 2025 State of the Disability Sector Report tells us

National Disability Services has released its latest State of the Disability Sector report, offering a comprehensive snapshot of provider sentiment, business viability and workforce conditions. Several findings stand out...

Financial pressure remains severe: A large proportion of providers are operating at a loss, with some reporting deficits of $500,000 or more. Around half continue to operate in the red, with another quarter only breaking even.

Market exits have not increased as sharply as anticipated: Although some providers have withdrawn, the overall exit rate has not risen dramatically in the past year. The highest levels of exit were recorded during the previous period. However, these data are likely drawn predominantly from registered providers, meaning the real picture for non-registered providers is less clear.

Workforce shortages remain a significant risk: Recruitment and retention continue to challenge providers across all disciplines. High turnover, wage pressures and competition from other sectors such as aged care are contributing to instability.

Complex clients face the greatest vulnerability: Some providers are reducing services or narrowing the complexity of clients they support. As financial strain grows, those with higher needs are at increased risk of losing access.

Despite the challenges, the report highlights ongoing resilience and adaptation. Many providers are diversifying, improving processes, investing in technology and strengthening internal capability.

What this means for OTs and the future of practice...

The current environment reinforces the need for deliberate planning and strategic development. Several themes are emerging for OTs...

Reassessing business models is essential: Understanding true cost of service delivery is more important than ever. This includes labour, compliance, supervision, non-billable time, travel, insurance and overheads. Pricing structures should reflect the genuine cost of providing high-quality services across all client types.

Internal workforce development is becoming increasingly important: With reduced funding and tighter margins, external supervision and training may become harder for some businesses to sustain. High-quality internal competency frameworks, clinical pathways and structured supervision systems are now critical. They ensure early-career practitioners are safe, supported and progressing towards advanced practice.

Complex caseload expertise will be in demand: As the sector shifts, practitioners with capability in complex needs, high-cost assistive technology, positioning, behavioural complexity and multi-disciplinary collaboration will be increasingly sought after. Building skills in complex practice areas protects service continuity for vulnerable clients and strengthens professional sustainability.

Providers must build clear client risk plans: Contingency planning is becoming essential. Participants need transparent information about provider availability, funding limitations and alternative pathways if services change. These conversations support informed decision-making and ethical practice.

New Evidence Advisory Committee consultation now open

The Evidence Advisory Committee has opened its December 2025 consultation round, seeking input on several supports: art therapy, music therapy, functional electrical stimulation, hyperbaric oxygen therapy, prosthetics containing neural interfaces, therapy suits... This follows recommendations from the Stephen Duckett review, which suggested a more detailed analysis of art and music therapy for specific cohorts. Anyone who previously made submissions to the Duckett review can resubmit the same material to this consultation round. Submissions close at 11.59pm AEDT on 20 January 2026. Feedback can be provided via online survey, PDF, written submission or video. Given the timing across the Christmas and summer period, practitioners who wish to contribute should plan ahead to ensure their voice is included.

Upcoming changes to payday superannuation

One confirmed change on the horizon is the introduction of payday superannuation, commencing 1 July 2026. Under this reform, employers will be required to pay super at the same time as wages, rather than on a quarterly cycle. For employees, this will mean faster super growth. For employers, it will require more consistent cash flow and financial planning. Service providers with multiple staff members will need stronger budgeting processes to ensure super obligations can be met weekly or fortnightly. Now is the time to begin modelling how this shift may affect business operations, payroll schedules and financial forecasting.

Key takeaways for OTs
• Sector pressures continue to intensify, making sustainable pricing and clear business models essential.
• Workforce development and internal training systems are becoming increasingly important as caseload complexity rises.
• Complex clients are at greater risk of losing services, creating an urgent need for clinicians skilled in advanced and high-needs support.
• Financial strains across the sector reinforce the need for unified allied health advocacy rather than discipline-by-discipline competition.
• The Evidence Advisory Committee is now seeking input on several supports, including art and music therapy, with submissions closing on 20 January 2026.

Useful Links

https://consultations.health.gov.au/evidence-advisory-committee-eac/december-2025/

https://nds.org.au/images/State_of_the_Disability_Sector_Reports/NDS8221%20NDS%20State%20of%20the%20Disability%20Sector%20Report%202025_FINAL.pdf

https://australian.physio/advocacy/NDIA-annual-pricing-review-report

https://www.ato.gov.au/businesses-and-organisations/business-bulletins-newsroom/payday-super-legislation-introduced