Care minutes bounce back as concerning reclassification trend emerges, Mirus reports

Care minutes totals have bounced back after a seasonal holiday dip in the latest industry analysis from Mirus Australia but there is reason to take stock of AN-ACC management styles as the age of AN-ACC reclassifications continues to rise.

Key points

• Mirus’ data sample, which represents roughly one-third of the residential aged care sector, shows a month-on-month 1.47% increase in total care minutes, averaging 204.62 per resident per day (PRPD) in January
• Registered Nurse minutes rebounded from December with a 3.27% increase, reaching 38.95 minutes PRPD
• Allied health minutes received a healthy 14.14% boost although it remained relatively low at 8.57 PRPD
• The Average Daily Subsidy (ADS) for the industry remained steady at $267.51, as did occupancy rates (88.58%), while the AN-ACC age increased to 63.92% and claiming activity dropped to 6.16%

While total care minutes have not recovered to the November high of 205.11, the January increase is a positive sign as the Christmas and New Year periods are often challenging times for workforce availability. Lingering seasonal impacts suggest February should be closer to November figures.

As for areas of concern, Rob Covino, Industry Lead and Founder of Mirus Australia, highlighted the AN-ACC age as one of the most interesting trends to come out of the switch from ACFI to AN-ACC in 2022. 

The AN-ACC age refers to the percentage of funding classifications that have not been reviewed or reclassified within the past 12 months, an important task to ensure funding aligns with workforce capabilities. With more than 12 months passing by since AN-ACC was introduced, Mr Covino said the trend is worth monitoring. 

“The industry is approaching the highest level of claims now over 12 months old since their last AMO assigned classification, exceeding 63% and still growing. This piques my interest as it’s approximately 15-20% higher than the aged ACFI dates,” Mr Covino said.

“The likelihood of a resident’s care needs remaining unchanged 12 months later is notably low. We often use this statistic, along with reclassification data, as an indicator of robust entitlement management practices at the reported sites.”

“For example, low voluntary reclassifications may suggest limited awareness and management of funding, while groups actively seeking reclassifications for their resident population indicate a proactive approach,” he added.

Mr Covino said Mirus Australia will investigate several hypotheses to better understand the trend and its potential impact on aged care providers. Two of the strongest hypotheses they will explore are:

Inadequate Understanding of Alignment with AN-ACC Class

As a relatively new funding model, there are knowledge gaps regarding the alignment of residents’ needs with AN-ACC classifications. Mr Covino said this hinders the ability to recognise funding changes or reclassifications and without additional insights into the classification algorithm, providers must rely on their instincts to identify residents who may be deteriorating beyond the level for current compensation.

Passive Approach to AN-ACC

Mr Covino identified the “do nothing” approach as a common trend for AN-ACC management. He said many providers are enjoying financial stability caused by consistent payments, which is both good and bad.

“This passive stance may become problematic once the index and budget enhancements plateau. A forthcoming period is anticipated where providers will experience the impact of slowed funding trends, particularly as the effects of increased staffed care minute payments materialise. 

“This challenge is compounded by providers potentially being out of practice with robust funding management principles, and the additional strain of implementing new reforms such as the ACT and Care Standards.”

Now may be the time to revisit AN-ACC strategies

Mirus Australia has previously shared that provider confidence levels in managing their AN-ACC care minute data vary considerably with roughly one-fifth of the sector unsure about the efficacy of their approach. 

With many providers requiring a new approach to funding management, rather than previous attempts at claims maximisation, it’s understandable that uncertainty remains over the best steps forward. However, aligning classifications and care time requirements with rosters allows providers to not over-stretch their resources.

Providers are certainly not resting on their laurels, though, as Mr Covino said there has been a recent rise in calls for identification and funding uplift services. Much of this has been buoyed by consultancies promising substantial financial gains, something to be wary of he said.

“This [uptick] is surprising given our initial expectation that such services would become obsolete with the implementation of the AN-ACC instrument, where funding aligns with the required care time. This mechanism was embedded by the RUCs study to eliminate funding maximisation strategies,” Mr Covino said. 

“However, several consultancies are actively marketing these services to providers, often guaranteeing substantial financial gains, such as finding $100k. This trend further underscores the observations around the increasing prevalence of claims exceeding 12 months.”