Physiotherapy Market Review – Findings and Next Steps

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Last year, ACC and Physiotherapy New Zealand (PNZ) jointly commissioned a physiotherapy market review, which was undertaken by independent reviewers Sapere. We’re now sharing the findings with you.

The review was commissioned to give a picture of how accident related physiotherapy services are working now, and to help guide future decisions. It looked at costs to deliver services, whether there are enough physiotherapists to meet demand, and whether there are opportunities to improve the way ACC commissions physiotherapy services.

What the review set out to do

The review was designed to provide a clear, evidence-based picture of the physiotherapy sector, including:

• the current sustainability of the physiotherapy market
• market configuration, provider landscape, and care pathways
• cost pressures and opportunities to improve efficiency
• client access, including geography, choice, and equity considerations.

The scope included physiotherapy services delivered under the Allied Health Contract and Cost of Treatment Regulations.

Key findings

Sapere’s analysis drew on a wide range of data sources, including surveys, sector engagement, and financial and market information. Key findings include:

• ACC-funded physiotherapy claims are increasing more rapidly than population growth and slightly faster than other ACC claims
• The physiotherapy workforce is unevenly distributed, and private practice workforce growth has exceeded population growth in recent years
• There are significant inequities by socioeconomic deprivation, ethnicity, and rurality
• The provider market is consolidating, with large practices gaining market share and now employing more physiotherapists than smaller practices
• Current ACC commissioning settings are contributing to pressure on Scheme sustainability, as well as causing equity and access challenges for New Zealanders
• Cost modelling shows ACC’s contribution is reasonable, enabling practices to cover their costs when combined with sufficient service utilisation and a suitable copayment. 

These findings provide a transparent, independent view of the challenges facing the sector and opportunities to improve how physiotherapy services are commissioned and delivered.

Acknowledging PNZ

We thank PNZ for the significant time and resource they have invested into this jointly commissioned, independent review, including agreeing on the scope, selecting the reviewer and providing feedback on the draft report.

We acknowledge PNZ may not agree with all of the review’s findings. ACC stands by the review, noting it was completed by experienced independent experts and based on a range of data and insights provided by the sector.

What happens next

ACC’s priority is delivering excellent outcomes for injured New Zealanders, while ensuring ACC remains sustainable for future generations. We want to ensure injured people get the right level of support, at the right time for their injury-related needs, within the boundaries of our legislation.  

We value the work of physiotherapists as important partners in helping New Zealanders recover quickly and get back to work and independence after injury.

This market review sets out a number of shared challenges. We remain committed to engaging constructively and collaboratively with the physiotherapy sector, including PNZ, as we consider how the review can inform and support future work to strengthen how we work together.

Upcoming webinar

We’re currently organising a webinar for Sapere to talk through the findings of the review. Once a date is confirmed we’ll send an invitation to register, along with details on how to submit questions ahead of the session.

Thank you

Thank you to the physiotherapy businesses and sector partners who contributed their time, data, and insights to the review. Your participation has been vital to ensuring the review reflects real-world experience and provides a strong foundation for future decision making.

Read full report