Support at Home: Lifeline or Looming Crisis for Smaller Providers?
As Australia’s Support at Home program edges closer, smaller home care providers fear being left behind. Prestige Inhome Care CEO Nick McDonald warns of affordability challenges, rising admin costs and the risk of an underground care market if consumers can’t keep up.
Last updated on 2 July 2025
Senior woman looking out the window at home
The Australian government’s upcoming Support at Home program promises a more sustainable home care system, but has providers worried about unintended consequences, especially for smaller organisations already stretched thin.
Nick McDonald, CEO of Prestige Inhome Care, warns that shifting from government-funded claims to direct consumer billing could hit small providers hard.
“There’s still a real ethos amongst older Australians that care should be free,” McDonald says. “Many believe that after paying taxes all their lives, aged care should be covered.”
Affordability is another flashpoint. If costs rise too sharply, some older Australians may forgo formal care altogether — or turn to an unregulated ‘black market’. “If people can’t afford care through registered providers, they might pay support workers under the table, leading to unsafe arrangements,” McDonald cautions.
He’s calling for practical solutions: market-driven pricing to keep rates fair and sustainable, higher funding ceilings for complex needs, and better support for family carers who save the government billions each year. McDonald also floats a bold idea — a dedicated Medicare levy for home care. “Why not introduce a similar mechanism for home care to stabilise the sector?”
Above all, he urges clear communication from government. “Providers are being left to explain the system, which makes us the ‘bad guys’ when clients push back on costs.”
As the rollout nears, all eyes are on whether policymakers can balance sustainability with choice and fairness — so smaller providers aren’t left behind.
Originally published in Hello Leaders winter print edition. Read the full article here or contact us on [email protected] to order your print copy.
Hayley Campbell, Content Writer
Changing resident expectations, ageing in place and increasingly complex support needs are reshaping retirement living. Dr Roger Pallant of the NSW Retirement Village Residents Association says leaders need to plan for that change and bring residents into the conversation.
Arun Thomas, Chairperson of ACNFFC
Australia has its first National Nursing Workforce Strategy, but a strategy alone won’t fix a 79,000-nurse deficit. Arun Thomas explores how the true test for health leaders lies in converting a 10-year policy blueprint into real, sustainable capacity on the ground.
Yvette Willison, Content Writer
After 15 years of planning, fundraising and refining a financially viable model, one rural Victorian community is still unable to build an aged care facility. Wedderburn’s experience raises broader questions about whether Australia’s regulatory framework can accommodate community-led solutions.
