The document, obtained by the Otago Daily Times, was prepared for the board, which just before Christmas announced it was moving from 17 to three providers, at the expense of Presbyterian Support Otago, which lost a $5.5 million contract.
The ideal number of providers was three, the document concluded.
''Having less providers reduces the complexity of the process and gives each one the benefit of having greater economies of scale to employ professional project management expertise.
''However, less providers also gives each provider greater long-term responsibility for managing a larger market share.''
Health professionals would supervise support workers and liaise with GPs, nurses, pharmacists, hospice teams and specialist services.
''To support the financial requirements of employing registered health professionals and increasing training, providers need to be able to minimise overhead costs in a limited budget such as office space and information technology infrastructure.''
Transferring clients and support workers to new providers required ''significant project and change management''.
The providers selected needed to be ones that could work together to achieve ''synergy'' on a joint service development team. Finance and funding director Robert Mackway-Jones, when contacted yesterday, acknowledged the risk associated with fewer providers, but this was ''absolutely'' outweighed by the benefits of choosing three providers over four.
''If you've got a lower number of providers in the mix...it increases the risk profile because if one's not [performing] you haven't got the opportunity for people to choose other providers to go to.''
However, the new service model would be of ''huge benefit'' to clients. The chosen providers are Access, Healthcare New Zealand, and the Royal District Nursing Service New Zealand. The new model will be phased in from next month.
When it put the service out to tender, the board said the maximum number of providers it would contract was four.
