This one is for practices that already have an established paediatric caseload. Not practices thinking about entering the space.
If that’s you, there’s a number you probably haven’t worked out yet, and it’s the number that should be driving your planning for the next eighteen months. It’s the share of your revenue attached to children aged eight and under funded through the NDIS with low to moderate support needs.
That’s your exposure. Most practice owners I ask haven’t calculated it. A few who have were surprised by how large it turned out to be.
First, a correction I need to make
Earlier this year I wrote that Thriving Kids would send a wave of funded families looking for providers, and that the job was to be findable when they arrived.
That was wrong, and I’ve since rewritten the piece explaining how the program actually works. The short version: families don’t receive Thriving Kids funding. The Commonwealth funds the states, with at least $1.4 billion of its $2 billion contribution going as direct funding to states, and the states commission services from there. Children reach clinicians through triage and commissioned providers, not by a parent choosing a practice.
In New South Wales, which has published the most detail so far, targeted supports are commissioned from non-government organisations with access through a central intake process run by the department. Private allied health professionals are engaged where a commissioned provider has a temporary capacity gap or lacks a needed specialisation.
I’m repeating that here because it changes the question this article is trying to answer. It isn’t “how do I capture Thriving Kids families.” It’s “how much of my business depends on a funding stream that’s being restructured, and what do I do about it.”
The scale of what’s moving
Thriving Kids is a $4 billion joint federal and state investment covering children aged eight and under with developmental delay and/or autism who have low to moderate support needs.
To understand how much of the paediatric sector that touches, look at the NDIS’s own numbers. As at 31 March 2026 there were 167,787 children younger than nine with an approved NDIS plan, out of 774,456 participants overall. Participation peaks sharply in early childhood, reaching around 11.5% of all Australian six-year-olds.
Roughly one in six of every NDIS plan in the country belongs to a child under nine. Not all of those children are in the low-to-moderate cohort, and children with permanent and significant disability keep their NDIS access. But it gives you a sense of why this reform exists and why the effect on paediatric allied health will be large.
The date that actually matters
October 2026 is when services start rolling out. It’s a beginning, not a deadline.
The date to plan around is 1 January 2028, when changes to NDIS access arrangements for this cohort take effect. Children aged eight and under already in the NDIS before that date will be reassessed against the eligibility criteria in place on 31 December 2027.
So the risk to your caseload arrives through reassessment, gradually, from about sixteen months out. That’s slower than most of the commentary suggests, and it’s more serious, because a slow loss of funded clients is easy to under-react to until the gap in your revenue is already there.
Working out your exposure
This is the practical bit. Go into your practice management system and pull three numbers.
One: how many active paediatric clients are aged eight or under and funded through the NDIS. Straightforward count.
Two: of those, how many would you expect to be assessed as low to moderate support needs. You’ll have to use clinical judgement here, because the assessment criteria for 2028 aren’t published. Be honest rather than optimistic. If you’re unsure about a child, count them as exposed.
Three: what those clients represent as a share of your total revenue. This is the number that matters, and it’s the one people avoid. Take the annualised billing for that group and divide it by total practice revenue.
If the answer is under 15%, you have a manageable problem and time to solve it. If it’s 30% or more, that’s a business continuity issue and it should be shaping your hiring, your lease decisions, and your marketing spend right now, not in 2027.
I’d also run the same calculation on your referral sources. If most of your paediatric enquiries currently arrive through support coordinators and NDIS pathways, that channel thins out at the same time the funding does. Two exposures, one cause.
Your existing families are still your first priority
This was the strongest advice in the original version of this article and it survives the correction intact. If anything it matters more now.
Your paediatric families are hearing fragments about Thriving Kids, and a lot of them have absorbed exactly the misunderstanding I had: that funding is coming to them and they’ll be able to spend it where they like. That’s a family heading for a difficult surprise, and how they experience that surprise depends largely on whether their provider prepared them for it.
Talk to them now. Find out what they think is happening, what they’re worried about, and what they’ve been searching. Being the practice that explained it clearly and early is worth more than any campaign you could run, and families who feel supported through a confusing transition tend to stay and tend to tell other parents.
There’s a commercial edge to this beyond the goodwill. Some of those families will lose NDIS funding and still want to continue therapy. Whether they continue with you as private clients is largely decided by the relationship you build before the funding changes, not after.
Replacing funded revenue with private revenue
This is the strategic work, and there’s no comfortable version of it.
If a meaningful share of your caseload is exposed, and you may not be commissioned to deliver Thriving Kids services, then you need demand that doesn’t depend on government funding. Practically, that means three shifts.
Convert what you can. Some exposed families will pay privately to continue. Work out roughly what proportion that might be, and what your private fee would need to be for the work to remain viable. Compare that honestly against what those clients bill now. Most practices find the gap is significant, which is exactly why this needs planning rather than hoping.
Focus on the cohorts that stay yours. Children with high support needs remain on the NDIS. So do school-age children over eight, complex presentations, and adolescents. Families who want more intensive or more specialised support than a commissioned community programme provides will also keep looking privately. Those are defensible parts of your caseload and they deserve deliberate attention.
Get genuinely good at generating your own enquiries. For a lot of paediatric practices, the NDIS has done the demand generation for a decade. Coordinators sent families, plans funded the work, and the calendar filled. Remove that and what’s left is your ability to be found and chosen directly by parents paying their own money, which is a completely different skill.
That’s ordinary marketing, and it’s the part practices have most often neglected. It means local search visibility for the services you want more of, a Google Business Profile that’s actually maintained, a website that converts the enquiries you’re already getting, and someone answering the phone quickly when a parent calls. None of it is Thriving Kids-specific. That’s rather the point.
What I’d stop doing
Two things from the earlier version of this article that I’d now actively advise against.
Don’t add “Thriving Kids provider” or “accepting Thriving Kids referrals” to your website, your Google Business Profile, or your ad campaigns unless you have genuinely been commissioned to deliver Thriving Kids services. For a registered health practitioner that’s a claim about your services you can’t substantiate, made to families making a decision about their child.
And don’t build Google Ads campaigns around terms like “Thriving Kids provider near me.” That search behaviour assumes families are choosing providers, which isn’t how access works. You’d be paying for clicks that lead nowhere useful.
What is worth doing is answering the questions families are genuinely asking. Parents are searching to understand what Thriving Kids is, how it differs from the NDIS, and whether their child will still get support. Content that answers that clearly, alongside a plain description of what your practice offers privately, is useful, accurate, and completely defensible. Explaining a government programme is fine. Claiming to be part of one isn’t.
The bottom line
There’s real uncertainty here. South Australia hasn’t published a service model. New South Wales is still consulting on how private practitioners fit. Anyone telling you confidently how this will work in your state is guessing, and I include my earlier self in that.
What isn’t uncertain is the direction. A large cohort of children will move out of individualised NDIS funding into a commissioned system, and most private practices will not be at the centre of that system. If your business depends on that cohort, you have about sixteen months to reduce the dependency.
Start with the number. Work out what share of your revenue is exposed, then decide how much of your attention that deserves.
If you’d like to work through it properly, where your exposure sits, where your enquiries actually come from now, and what’s worth building first, that’s exactly what a Clinic Growth Diagnostic is for.