Thriving Kids begins on 1 October 2026. For allied health practices with significant paediatric caseloads — particularly those serving children aged 0 to 8 with developmental delay or autism and low to moderate support needs — this is the most significant revenue event since the NDIS launched.
Most of the commentary on Thriving Kids has focused on the policy design and the operational implications. This article focuses on the financial modelling that practice owners need to do right now — before 1 October — to understand the revenue impact, protect their cash flow, and make informed decisions about their practice’s future.
What Thriving Kids Changes — The Short Version
From 1 October 2026, the government begins providing supports for children aged 0 to 8 with developmental delay and low to moderate autism support needs outside the NDIS. From 1 January 2028, new applicants in this cohort will be directed to Thriving Kids rather than the NDIS.
Existing NDIS participants in this cohort will continue to be reassessed under pre-2028 eligibility criteria. But the pipeline of new paediatric NDIS participants will shrink significantly from January 2028.
Combined with the 10% CBDA budget reduction from 1 October 2026, paediatric-heavy practices face a compound revenue challenge: existing budgets are being cut while the pipeline of new participants is being redirected.
How to Model the Financial Impact on Your Practice
The starting point is understanding your exposure. Answer these questions:
- What percentage of your current NDIS revenue comes from participants aged 0-8?
- Of those participants, what percentage have developmental delay or autism with low to moderate support needs (vs high support needs)?
- What is the average annual NDIS revenue per paediatric participant in your practice?
- What is your current plan renewal cycle? (Participants with plans renewing after 1 October 2026 will face the 10% CBDA reduction)
Once you have these numbers, you can model three scenarios:
- Base case: 10% CBDA reduction applies to all paediatric participants, no change in participant numbers
- Moderate case: 10% CBDA reduction plus 20% reduction in new paediatric referrals from 2027
- Stress case: 10% CBDA reduction plus 40% reduction in new paediatric referrals and 15% attrition of existing participants transitioning to Thriving Kids
The Valuation Impact — What Thriving Kids Does to Your Practice’s Worth
Practice valuation is based on sustainable, repeatable earnings. A practice that is heavily dependent on a revenue stream that is being structurally reduced will be valued at a discount to one with a diversified, stable revenue base.
If your practice generates $1.5M in revenue with 60% from paediatric NDIS, and Thriving Kids reduces that stream by 20% over 3 years, your sustainable revenue drops to approximately $1.32M. At a 20% EBITDA margin, EBITDA drops from $300,000 to $264,000. At a 3× multiple, practice value drops from $900,000 to $792,000 — a $108,000 reduction in value from a policy change you can’t control.
The practices that will maintain or grow their value through Thriving Kids are those that:
- Diversify their revenue mix before 2028 (increase adult NDIS, Medicare, private billing, Support at Home)
- Position to deliver Thriving Kids services directly (NSW has contracted not-for-profits, but other states may create different pathways)
- Increase their AHPI score — practices with strong commercial fundamentals attract higher valuation multiples regardless of revenue mix
Tax Planning for Revenue Diversification
Diversifying away from paediatric NDIS into adult NDIS, Medicare, or private billing has tax implications that need to be planned for:
- Medicare billing: Bulk-billed Medicare services are GST-free. If your practice currently has minimal Medicare billing, adding a significant Medicare revenue stream changes your GST position and may require a BAS review.
- Private billing: Private (non-Medicare, non-NDIS) billing is subject to GST. If you’re moving from a predominantly NDIS model to a mixed private model, your GST obligations increase.
- Support at Home: Aged Care Support at Home services are GST-free. Entering this market requires understanding the GST treatment of each service type.
What to Do Before 1 October 2026
- Model your exposure: Calculate the exact dollar impact of the 10% CBDA reduction on your paediatric revenue
- Review your plan renewal schedule: Participants with plans renewing after 1 October face the cut. Know when your participants’ plans renew.
- Start revenue diversification now: Don’t wait until 2028. The practices that will be best positioned are those that start building alternative revenue streams in 2026.
- Review your business structure: If Thriving Kids materially changes your revenue mix, your current trust or company structure may need to be reviewed.
- Take the CARE Assessment: The free CARE Assessment will score your practice’s Risk & Resilience dimension and identify your specific exposure to Thriving Kids and NDIS reform.
Thriving Kids is a policy event with financial consequences. The practices that plan for it now will be in a fundamentally different position to those that react to it in 2027. Shuriken Advisory Group works with allied health practice owners to model these scenarios and build the financial structures that protect practice value through reform cycles. Contact us or take the free CARE Assessment to start.
