ACC's board chair says if they don't act now, the scheme will become unaffordable. Photo: Supplied
Hiring more case managers and getting more non-serious injury clients out of the long-term claims pool are part of the Accident Compensation Corporation's (ACC) plan to get its finances in order and avoid a $26 billion deficit.
ACC has released its turnaround plan, which it hopes will improve its performance and get the scheme back to basics.
In her foreword to the turnaround plan, ACC board chair Jan Dawson noted more people were taking longer to return to work or independence, particularly those with non-serious injuries, and it was driving up costs.
Last year, Dawson said ACC spent $8.1 billion on rehabilitation, treatment, and compensation - $4.9 billion more than a decade ago.
In that time, the number of clients accessing weekly income compensation for more than a year had grown from around 12,300 to 24,500.
ACC estimated it could have an overall funding gap of $26.3 billion by 2030 if changes were not made.
"If we don't act now, the scheme will become unaffordable, challenging its ability to support future generations," Dawson said.
The report noted ACC had taken a more "generous" approach in its decision-making, which had led to over-servicing some clients, providing more expensive support for longer than required, and funding "unnecessary" services that were not directly related to a client's injury needs.
Many clients who had spent more than a year on weekly income compensation did not have serious injuries, and should be able to return to work or independence faster if they had the right support.
"Receiving unnecessary support isn't good for clients or the scheme. It can delay recovery or lead to ongoing reliance on support. It also puts financial pressure on the scheme and means levy payers are funding costs that should be met by the wider government system."
In response, ACC said it would introduce a "temporary dedicated team" to review claims which may be over-serviced, scale up its fraud prevention and investigation capabilities, and review surgery decisions to ensure they were "directly related to injury, evidence-based and appropriate".
The agency intended to appoint 285 more claims management staff, with a focus on getting non-serious injury clients out of the long-term claims pool and back to work.
A 28-day mark check-in would be established for clients accessing weekly compensation who were at risk of delayed recovery.
A separate review of ACC by consultancy firm Finity called for a 'back to basics' approach of effective and efficient claims management.
Finity's report, released alongside the turnaround plan, said ACC should pause "non-core transformational projects" and focus on remediating claims management.
Finity noted that while there was much to admire about ACC, its rehabilitation performance had declined, and there had been a loss of operational focus.
"The organisation has good intent and foundational elements in place, but until recently, efforts have been
fragmented, slow to be embedded, and undercut by a lack of focus on core claims management. Without
urgent and disciplined action, the trajectory will not improve meaningfully, and claimants, levy payers, and
taxpayers will continue to bear the cost," the report said.
The government had previously set expectations of ACC to better manage its costs and improve its performance, with a particular focus on the long-term claims pool.
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