Public Annotation – FYI.org.nz Request #32671**

ACC Expenditure by Contract and Provider Type (Across Allied Health, ICP-MSK, Concussion, Pain Management) (Updated 18 November 2025)

This Official Information Act (OIA) request—submitted by **M D Stewart**—seeks detailed breakdowns of **ACC expenditure over the past three financial years**, focusing on major treatment contracts and provider categories within the ACC system. It asks for a level of clarity that ACC very rarely publishes proactively, making this request significant for public transparency.
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What the Request Seeks

The requester asks ACC to disclose expenditure for:

1. Allied Health Services Contract

* Total spending for each of the last 3 financial years
* Breakdown by:

* Physiotherapy
* Hand therapy
* Podiatry

2. Integrated Care Pathway – Musculoskeletal (ICP-MSK)

A more recent ACC initiative that bundles multi-disciplinary care.
Breakdowns sought for:

* Physio
* Chiropractic
* Acupuncture
* Osteopathy
* Podiatry
* Occupational therapy
* Radiology

3. Concussion Services Contract

Breakdown by:

* Occupational therapy
* Physiotherapy
* Radiology
* Medical practitioner costs
* Clinical/Neuropsychology

4. Pain Management Service (PMS) Contract

* Total aggregate expenditure
* Allied health breakdowns (including chiropractic, acupuncture, osteopathy, OT, physio, podiatry)
* A separate request for PMS-related treatment under the **Cost of Treatment Regulations**
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Why This Request Matters

This request addresses a **long-standing transparency gap**:

* ACC publishes high-level annual expenditure, but
* **does not routinely release contract-level or provider-type breakdowns**,
* even though ACC distributes **hundreds of millions** annually through these pathways.

Knowing how much funding flows into each discipline helps the public understand:

* ACC’s **treatment priorities**
* Shifts between traditional allied health services and newer **integrated pathways**
* Whether public money is being spent **efficiently, equitably, and transparently**

This information is also crucial to:

* **Allied health professions** (e.g., physios, OTs, podiatrists, chiropractors, acupuncturists)
* **Researchers and journalists**
* **Policy analysts** following ACC’s contracting evolution
* **Claimants and advocates** examining treatment access, delays, or inconsistencies
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Current Status (as of 18 November 2025)

* ACC has acknowledged the request, as per standard OIA practice.
* No data, spreadsheets, or partial release has yet been provided.
* The request may be nearing or past the **20-working-day statutory timeframe**, depending on ACC’s date of receipt.
* No notice of extension or consultation has been posted.

A follow-up may be required if ACC:

* fails to provide data,
* issues a blanket refusal under s 18(f) (“substantial collation or research”),
* or uses “commercial sensitivity” to withhold provider breakdowns.

If so, the requester may escalate to the **Ombudsman**.
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Historical Context: Prior FYI OIA Requests

This request builds upon earlier transparency efforts:

**FYI #10934 (2019) — Claim & Payment Breakdown by Therapy Type (2017–2019)**

ACC released detailed spreadsheets breaking expenditure into physiotherapy, acupuncture, chiropractic, osteopathy.
👉 *This sets a clear precedent for releasing provider-type breakdowns.*

**FYI #955 (2013) — ACC Spending on “Alternative Therapies”**

ACC supplied ten years of historical funding data for acupuncture, osteopathy, and chiropractic.

Earlier requests focused on so-called "alternative therapies," whereas newer OIAs (including #32671) examine **system-wide contracting**, reflecting:

* ACC’s shift toward **bundled care models**
* Increased public interest in **cost-effectiveness** and **provider utilisation**

Given these precedents, ACC should be able to supply equivalent data for ICP-MSK, Concussion Services, PMS, and Allied Health Services.
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**Public Interest & Transparency Considerations**

This OIA is of high public interest because:

* Contract-level spending affects **treatment availability** and **wait times**.
* Some disciplines (e.g., neuropsychology, podiatry, acupuncture) report **inconsistent funding or access**.
* ACC’s Integrated Care Pathways are currently under scrutiny for:

* inconsistent rollout
* regional inequities
* unclear funding distribution
* limited public reporting

Additionally:

* Spending patterns influence **rehabilitation outcomes**, **clinical priorities**, and **contract renewals**.
* Fiscal transparency is necessary because ACC is funded by **levies, taxpayer contributions, and investment returns**.

Public access to these numbers allows independent:

* benchmarking,
* scrutiny of value-for-money,
* analysis of health-sector planning,
* and identification of potential inequities between professions.
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**Guidance for Observers / Analysts**

Once ACC releases the data (typically CSV or spreadsheets), readers will be able to:

1. **Compare spending year-to-year**
– look for increases or declines in certain provider categories.

2. **Map provider utilisation**
– e.g., has physiotherapy spend decreased under ICP-MSK?
– has chiropractic spend increased or decreased?

3. **Identify policy shifts**
– growth in integrated pathways
– movement away from individual provider-based models to multi-disciplinary contracts.

4. **Assess equity between provider types**
– are some professions underfunded despite high injury prevalence?
– is radiology over- or under-utilised?

5. **Support advocacy or reform**
– professional groups can use the data to argue for fairer contract terms or access.
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**Annotation Summary (for FYI page)**

> **This request (#32671) seeks three years of contract-level and provider-type expenditure data from ACC across four major treatment pathways (Allied Health, ICP-MSK, Concussion Services, and Pain Management).**
>
> The information has high public value because ACC does not routinely publish detailed breakdowns showing how levies and public funds are distributed across different treatment modalities. Earlier FYI requests show clear precedent for providing such data.
>
> As of 18 November 2025, ACC has acknowledged the request but has not yet released any data. Observers may wish to monitor for updates or follow up if ACC claims commercial sensitivity or excessive collation, as neither ground generally applies to aggregated contract-level expenditure.
>
> Release of this information would significantly improve transparency around ACC’s funding priorities and allow independent assessment of whether treatment pathways are being resourced proportionally and equitably.

Public Annotation

This OIA gives the public a rare, detailed look at ACC expenditure across major treatment contracts. ACC has released substantial data, which is helpful, but the refusal to provide the provider-type breakdown for the $70.8 million ICP-MSK contract is significant and consistent with a wider pattern.

Across FYI, ACC repeatedly refuses granularity for ICP-MSK despite providing similar breakdowns for other contracts (Allied Health, Concussion, Pain Management, etc.). The explanation given — that the data cannot be collated without unreasonable effort (s18(f)) — is questionable, because ACC clearly records provider types internally for contract management, payment, and auditing.

ICP-MSK is ACC’s fastest-growing contract, increasing 400% in a single year (from $13.6m to $57.2m). The absence of provider-type transparency prevents the public from seeing whether the model is truly multi-disciplinary or dominated by a single provider discipline (e.g., physiotherapy). This also makes it difficult to assess cost-effectiveness and equity across professions.

Large sums coded to “Unknown” or “Electronic Billing Provider” across multiple tables reflect a repeated transparency issue seen in other ACC OIAs. If ACC systems cannot identify who is being paid, that itself raises accountability concerns.

Given the size and rapid expansion of ICP-MSK, the requester may wish to seek an Ombudsman review of the refusal, as the public interest in transparency is strong and growing.