Provider insight: How consumer co-contributions benefit aged care

Aged Care Taskforce members have shared their insights into their final report and recommendations following its public release on Monday evening, responding to provider questions in the Department of Health and Aged Care’s webinar yesterday.

Key points:

• The Taskforce made 23 recommendations that fall into three main categories: Support older people to age in place; Equitable and sustainable funding; and Quality, innovation and transparency
• Key recommendations include wealthier Australians paying more for aged care services and the eventual removal of upfront refundable accommodation deposits (RADs) for residential care
• Where older people cannot contribute to the cost of their aged care services, a safety net has been recommended to ensure they are supported at all times

Speaking in Tuesday’s webinar, Tom Symondson, CEO, ACCPA, said the report grapples with some of the toughest issues in aged care, such as achieving sector sustainability. 

“The whole purpose of the Taskforce and its report was to put aged care on a sustainable footing, not just now but in five, ten or 20 years so the ageing population can be confident that aged care will be there and capable of providing the high-quality care the Royal Commission challenged us to deliver.,” Mr Symondson said.

Consumer co-contributions are viewed as one of the most impactful ways to achieve sustainability, particularly as Australia will require more aged care services for a growing older population. 

Nigel Ray, Deputy Chair, Aged Care Taskforce, said the Government would continue to be the main funder of aged care if it adopted the co-contributor model as it would help improve access to home care, service quality and sector viability.

Some concerns were raised about what older consumers would be funding after it was suggested they should continue to pay for expenses such as cleaning and gardening because they have paid for them as adults. In a question posed to Mr Ray, the view was labelled “out of touch”. 

“What we are suggesting is that those sorts of services are those which it would be possible for people to make larger co-contributions towards, so we’re not saying pay the whole lot,” Mr Ray said.

“We’re saying make a contribution towards provided people have the means to do so. There would be a strong safety net and it would be based on the capacity to pay, not a blanket across the board.”

When asked if allied health services would be fully funded by the Government or as part of consumer contributions, Mr Ray added that it’s a matter for Government but it should be included on the services list that receives funding, particularly for home care recipients as it is helping them age in place. 

Will providers be debt collectors?

The introduction of consumer contributions may not be welcomed by all – although the Government is confident that stakeholder surveys show Australians are willing to pay more for their services – which left some providers worried they would have to chase additional funds.

Mr Symondson said provider protections in this regard would have to be built into the system’s design. 

“It is challenging to be seen as a debt collector. That has to be part of the response to the recommendations. What we’ve focused on is should contributions exist. The challenge is  if we increase the amount of co-contribution that people are asked to make it will become an administratively complex system; it’s already administratively complex,” he said.

“Whatever comes out of these recommendations has to be simpler, it has to be less difficult to implement. It has to be less difficult for consumers to understand than the current system but it also has to be easier for providers to implement so we’re not wasting time and effort on administering the system.”

Recovering billions in unspent funding

The home care sector is currently in a pit of murky waters as its funding set-up has resulted in a reported $3.2 billion of unspent funds, according to Grant Corderoy, Partner, Stewart Brown. He said this has been a constant area of concern as for every dollar of funding, providers are only delivering a service just under 85 cents per dollar. 

“The way it’s designed at the moment, people aren’t using all of their funds in the majority of cases. That unspent amount is continuing to increase and at the moment it’s idle money sitting with the Government at Services Australia, not in the balance sheets or the bank accounts of providers,” Mr Corderoy said.

Mr Corderoy added that Support at Home should act as a clean slate for home care funding as there will be greater clarity surrounding what services are provided, how much they cost, and how much participants need to contribute. 

Additionally, he said the Aged Care Taskforce’s job was to discover how it could improve funding to support the delivery of everyday living needs, particularly for residential care providers.

“In residential care, food, catering, cleaning, utilities, accommodation… that’s where the sector has become unsustainable. We always made a margin in our direct care [but] we’ve lost in our everyday living and our accommodation for 10 or 15 years,” Mr Corderoy added.

A holistic approach to keep people at home

Another focal point of the webinar was how the Taskforce recommendations support older people to age at home and ensure they do not enter aged care earlier than necessary.

As part of the co-contribution model, Government funding would be prioritised towards care minutes: nursing care, supporting people to wash or eat and supporting people through home care services. Consumer co-contributions would touch on the everyday elements highlighted earlier: gardening, cleaning, activities and lifestyle.

Therefore, Mr Symondson said by assessing people’s ability to pay for additional services, providers can be better funded to deliver those services through weather consumers. Others would have a safety net to fall back on, but either way, they can access holistic care in the comfort of their own homes.

“I know this is something often said ‘As long as I’m getting my gardening and cleaning done, that’s what I need to stay independently in my home’. But we have $2.3 billion of unspent home care package funding,” he said.

“We are often seeing people moving into residential aged care because they have not been able to adequately support their own health needs either because they couldn’t access services or because they chose not to.”

Mr Symondson said holistic support is essential, including a focus on keeping homes liveable and people connected with their community and routines, to avoid forcing them into residential aged care earlier than necessary. 

The full final report of the Aged Care Taskforce can be found on the Department of Health and Aged Care’s website. The webinar recording is not yet available online.