Nine weeks. That’s how long one Victorian remedial massage therapist says she has waited to be paid for services delivered under Support at Home.
With another provider, the wait stretched to 10 weeks.
And payment delays aren’t her only frustration. Working across several aged care providers means navigating different onboarding requirements, work orders and compliance processes.
“If I were relying on this as my primary income, I would not be able to survive,” she laments.
As providers continue to adjust to the structure of Support at Home, her experience raises questions about what Support at Home administration fees, payment processes and compliance requirements mean for the small businesses delivering services.
Support at Home payment delays hit cash flow
Payment terms of approximately 30 days are written into the therapist’s provider agreements and are non-negotiable.
But 30 days doesn’t always mean 30 days.
“If an invoice misses a payment run, it can take two to three weeks to have it rectified,” she said.
She invoices two providers weekly, which means she is generally paid weekly once the payment cycle begins. Another pays monthly, making missed payments harder to absorb.
Under Support at Home, Services Australia expects to process and pay registered provider claims within seven days. Payment arrangements between registered and associated providers are then managed by the providers themselves.
For small businesses, Support at Home payment delays can put significant pressure on cash flow.
Support at Home provider compliance varies
The therapist says Support at Home provider compliance also varies between organisations.
Requirements range from insurance and police checks to vaccination records, rates and bank details. Keeping those documents updated across different providers takes time.
Work orders aren’t consistent either.
“Some providers send a work order for x number of sessions, others stipulate once per week for x number of weeks,” she said.
Others send weekly schedules or approve services without a clear end date.
“I have had to tell a new Care Partner how to write her own company’s Work Order!”
“Central registration would make life so much easier for sole traders,” she said.
Rather than uploading the same compliance documents to multiple providers, she wants a system where independent workers can register once and provide their registration number.
Price transparency remains a sticking point
Then there’s the question of what participants pay.
“I have no way of knowing what my providers are charging unless my clients tell me,” she said.
Under Support at Home, providers set their own prices, but those prices must be reasonable and transparent. Separate administration fees cannot be charged, although administration and other costs can be included in the overall service price.
Where a self-managing participant directly sources a third-party worker, provider overheads are capped at 10% of the cost of that service.
The therapist says some clients have told her their provider adds around 10% to her invoice. With another provider, she says the invoices are too complicated for her clients to determine exactly what they are paying for remedial massage.
The opaque fees and the rollout itself (more broadly) has also faced considerable scrutiny through the Support at Home Senate inquiry.
Is complexity limiting consumer choice?
For the therapist, the bigger concern is whether the administrative load is making providers less willing to work with independent practitioners.
She says some providers won’t onboard new remedial massage therapists because of the compliance involved. It’s creating a problem for established client relationships.
“I may have been seeing a client for 10 years in private practice, but if they choose to sign up with a provider I am not registered with, it’s likely I wouldn’t be able to continue to treat them,” she said.
“So much for consumer directed care.”
Registered providers remain responsible for ensuring third parties meet aged care legislation and the Aged Care Quality Standards. But with uncertainty around Support at Home already affecting provider planning, payment and onboarding processes are another area for leaders to watch.
For this therapist, the current arrangements wouldn’t be sustainable if she depended on this work for her family’s income.
“If I were relying on this as a sole family income, then no, I wouldn’t continue.”
