Will Support at Home actually reduce costly home care waiting periods?

The shift to a brand new home care system in 2025, Support at Home, brings plenty of optimism. Older Australians will have more opportunities to age at home thanks to increased funding and more extensive support options.

Underneath the glossy top coat of Support at Home is a host of concerns. For one, wait times for Home Care Packages have ballooned and there’s no short-term relief in sight.

Then there are the seemingly significant funding cuts to care management payments, the added complexity of additional care levels and the daunting prospect of new administration challenges.

This means home care providers could be left with reduced revenue, additional admin requirements and increased demand in both metropolitan and regional areas. 

Tackling home care’s long wait times 

One of the biggest problems with home care right now is the long wait time between applying for a package and actually receiving one.

The most recent data shows that the approximate wait time for level 3 and 4 packages is 9-12 months, with level 2 packages sitting at 3-6 months and level 1 just one month.

Waiting periods of up to 12 months, or more, are costly for those requiring high levels of care. With many people requiring a level 4 package usually needing 24/7 care – they are essentially one step away from entering residential care – they don’t have the time to wait for a home care package.

And if families can’t pay privately for home care support, the person will end up moving into permanent residential care when timely support could have kept them at home.

The Government aims to reduce all wait times to three months by 2027 thanks to the reforms associated with the Aged Care Act, which includes creating support for an additional 300,000 participants over the next decade. 

Aged care consultant and Invox representative, Paul Sadler, told Hello Leaders this is likely a realistic timeframe to reduce wait times as he doesn’t believe they could do it any faster. 

Regardless, supply is not meeting demand. Data from January – March 2024 revealed that almost 60,000 people were waiting for a Home Care Package with approval rates and the number of people receiving a package increasing by about 10% compared to the previous year.

With 24,100 new Home Care Packages released this year, the Government will have to up the ante to meet growing demand, especially for level 2, 3 and 4 packages (and likely the relevant classifications under Support at Home.

The highest number of HCP approvals in the March quarter were for Level 3, comprising 40%, followed by a fairly even split for levels 2 and 4 which recorded 28% each. 

In a statement provided to Hello Leaders, a spokesperson for the Department of Health and Aged Care said relevant data on the impact of the additional HCPs is not yet available. 

“Wait times for high-priority packages will continue to be less than one month. A number of factors impact wait times for medium priority packages, and are being closely monitored as we release additional packages,” they added. 

More than just one burning issue

As highlighted above, the Government plans to create 300,000 new Support at Home places over the next decade. It’ll achieve this by investing $4.3 billion into the program over that same time. This will ensure supply meets demand.

Except for the fact it’s up to the providers to deliver that supply and they are dealing with a profound number of burning issues. 

One of these issues Mr Sadler highlighted is the fact service providers will only be able to access 10% of participant budgets for care management fees. He questioned whether it “would be affordable to provide care management” moving forward at a fee significantly lower than the 20% currently allowed.

Further analysis by Invox shows the 10% threshold will be a 5.9% reduction from the average percentage of a package currently allocated to care management. In terms of the real impact on providers, though, they believe it will be closer to a 38.5% decrease in care management cost recovery.

“We compared the current HCP level 3 with the financially equivalent new SaH Class 5, using the Government’s ‘National summary of Home Care Package prices – 30 June 2024’ as the benchmark. We found that providers will receive $2,500 less per client, per year for care management,” Invox explained.

“This analysis is based on the current average cost of care management at $248 per fortnight against the new 10% of a package value equal to $152 per fortnight. That’s a massive $750,000 per annum negative impact on a provider with 300 packages.”

Another critical issue is going to be the administrative burden on providers. The No worse off principle ensures existing HCP clients and those approved for a Package will not pay more for their services. 

Therefore, with ten new classifications (including two short-term care options) and three separate service types (clinical, independence services and everyday living), service providers will be juggling existing HCP arrangements and new Support at Home arrangements at the same time.

“The government’s commitment to grandfather everyone on existing packages means that some people on current packages at age 65 could be on that package fee level for another 35+ years,” Invox added. 

“This means organisations will need to account for the ten new types of packages plus the four old fee levels making 14 differing sets of complex fee arrangements to be implemented across two different fee systems for over 35 years!”

Challenges are to be expected when shifting to a new program. However, it’s clear the grandfather clause for existing aged care participants is going to add complexity to an already unfamiliar system. Time will tell if this impacts the Government’s goal of reducing home care waiting periods.