‘Financial incentives for GPs’ one of the wide range of ideas cash-strapped ACC considered
Wednesday, 20 May 2026
Government officials appear to envisage rewarding doctors for getting patients off ACC and back to work faster, in a bid to improve the accident insurer’s finances.
However, the state-owned insurer has indicated its intentions may have been lost in translation and says they do not include “additional payments or bonuses linked to individual patient outcomes”.
A draft Cabinet paper titled “Getting ACC Back on Track”, which was prepared for ACC Minister Scott Simpson, said “financial incentives for GPs and primary care providers to those that support clients back to work” would be explored.
The paper was submitted in August by the Ministry of Business, Innovation and Employment (MBIE) and the Public Service Commission after consultations with Treasury, but was released only earlier this month.
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The advice was prepared while ACC was seeking ways to curb a burgeoning deficit and shortly after the Government drafted but then shelved a law change that would have axed the right of victims of sexual abuse to claim more than $3 billion of compensation for lost wages by narrowing the scope of ACC cover.
The draft Cabinet paper did not spell out what incentives officials envisaged providing to GPs, or in what circumstances.
Professor Lynn McBain, head of the department of primary health care at Otago University in Wellington, said directly paying clinicians to get patients off ACC would cross a line, but doubted that would ever have been considered.
“I can’t imagine that they would actually mean ‘if you get John to go back to work, we’ll give you a bonus’, because that would be completely inappropriate. No GP would engage with that sort of behaviour anyway.”
ACC deputy chief executive Lisa Williams distanced the state-owned insurer from the statement in the draft Cabinet paper, noting it had been written by MBIE and characterising it as one of “a wide range of ideas” that was considered during the development of ACC’s turnaround plan.
The finalised plan, as published by ACC, does state that one of its goals is to “align commercial incentives for primary care providers to support return to work outcomes for clients and more consistent certification practices”.
But Williams said she acknowledged ACC’s use of the term “commercial incentives” was not clear, and that it was “not about paying bonuses or introducing at‑risk pay”.
“It’s about how ACC, as a public purchaser, can use contracts, and the pricing and performance measures specified within them, to encourage high‑quality, timely and efficient services.”
That approach was being explored through “test and learn” contracts with five medium-sized health providers, she said.
The stated goals of those contracts include reducing “confusion” about what support ACC clients can access with each medical certificate and “managing expectations from clients and employers about when someone needs to be fully unfit for work”.
“Over recent years, ACC data has shown that more New Zealanders are taking time off work for low complexity injuries, with their recovery times getting longer,” ACC said when explaining the initiative in March.
Williams said the contracts were about ensuring “injured people get the right level of support, at the right time”.
In December, the Treasury forecast ACC’s funding deficit would rise from $13.8 billion to reach $16b at the end of June, before climbing to $23b by June 2030.
In January, Simpson unveiled an ambitious “turnaround plan” that envisages ACC will return its books to a $2b surplus by 2030 through performance improvements and with the benefit of accounting changes that should wipe about $12b off its funding deficit on paper.
He said decisions about how the turnaround plan was implemented were an operational matter for ACC.
The Treasury is expected to incorporate some, but not all, of the assumptions in the turnaround plan into its financial forecasts for ACC when the Budget is released on May 28.