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.
Amy Henderson, Contributor
As the pace of aged care’s market consolidation intensifies, so too must the conversation of one size fitting all. Honeybee homes is a ‘tiny’ provider on NSW’s north coast that is bucking the trend. A 30-year wait list shows they’ve captured demand in a big way.
Marion Piper, Contributor
Fewer than half of aged care providers are meeting care minute targets. As nursing shortages worsen, meeting targets isn’t just about headcount – it’s about using technology to reduce friction, eliminate unnecessary administration, and support clinical teams on the frontlines.
Hayley Campbell, Content Writer
Australia’s aged care workforce already relies heavily on migrant workers, while demand for workers continues to grow. With migration settings under review, providers need to understand what changes to access for overseas workers could mean for staffing.
