Underfunded care management risks Support at Home quality

Australia’s aged care sector is once again under pressure from within as the very reforms intended to strengthen it pose an unnecessary risk.

As the Australian Government prepares to roll out the new Support at Home program, a coalition of community-based care providers is raising alarm bells about a critical flaw: underfunded care management fees that could threaten service quality, provider viability, and the well-being of older Australians.

The Royal Commission into Aged Care Quality and Safety recommended a rights-based, person-centred care system with skilled care managers guiding older Australians through increasingly complex health and aged care services.

This included Recommendation 31, which stated care management should be scaled to match the complexity of needs, and that care managers should have relevant qualifications and suitable experience for the range and complexity of care needs.

Yet, under the new model, the government has capped funding for care management at just 10% — far below the industry standard of 17% and the previously allowable cap of 20%.

A system under strain

The coalition features seven experienced Chief Executive Officers from small to mid-sized home care providers: Danielle Ballantine, Your Side Australia; Helen Crouch, Hornsby Ku-ring-gai and Central Coast Community Transport; Kaz Dawson, Proveda; Christina Harlamb, Focus Care; Joseph McCarthy, Novacare; Matthew Adderton, MWP Care; and Ka Chan, JobQuest.

They are united in saying that the consequences of underfunding are already being felt.

“Aged care providers warn that the current funding model will result in a decline in service quality, workforce skill levels, and provider availability. Without urgent attention, older Australians will face increased health risks, financial barriers, and reduced access to high-quality care management,” the coalition states.

It has identified the following six key issues in aged care management.

1. Deskilling of the workforce: As professional roles are downgraded to cut costs, vital responsibilities are being shifted to family members — often women — or to lower-paid, less-trained staff, undermining care quality and staff retention.
2. A challenging model: The Support at Home model itself presents a major challenge for providers and older Australians. The complexity of the new two-tiered funding system (Commonwealth Support at Home Programme and Support at Home) and multi-tiered client contributions will only increase these challenges.
3. Rising compliance risks: Sector Performance Reports from the Aged Care Quality and Safety Commission reveal growing failures in care planning, clinical care, and governance. Nearly a third of providers failed to meet governance standards in the most recent quarter. Reduced care management funding could lead to increased risks to older Australians and a loss of public trust in aged care reforms.
4. Consumer dissatisfaction: Complaints about communication, unexpected fees, and poor financial management have surged. The complexity of the new co-contribution model only adds to the confusion and mistrust.
5. Provider instability: Delayed payments and increased administrative loads risk pushing smaller providers out of the market, reducing choice and creating service gaps in local communities.
6. Heightened risk to older Australians: Without comprehensive care management, preventable hospitalisations, falls, medication errors, and cases of elder abuse may rise.

The benefits of properly funded care management are vast, according to the coalition. It says that care management is vital for improving the quality of care, supporting families, assisting in navigating health and aged care systems, reducing the risk of elder abuse and neglect, and preventing higher-cost health interventions.

An urgent call for action

The provider coalition is calling on the government to urgently review the Support at Home funding framework. Their recommendations include:

• Restoring care management funding to at least 17%
• Recognising care management as a core service, not just an overhead
• Investing in the care management workforce through training and career development
• Addressing payment delays and administrative burdens for providers
• Ensuring the co-contribution model doesn’t exclude vulnerable Australians from accessing essential care

“Failure to act will weaken Australia’s aged care system, endangering older Australians and diminishing public confidence in government-led reforms. Immediate policy adjustments are needed to safeguard quality, person-centred aged care services,” the coalition added.

With aged care reform at a critical juncture, the sector’s message is clear: quality care requires qualified care managers, and those roles need proper funding to succeed. If they are not properly funded, Australia risks repeating past failures, this time under the guise of reform.