Data study predicts increasing CHSP demand, expenditure

The target population for CHSP-level services is expected to hit almost 5.5 million over the next ten years with expenditure on CHSP estimated to grow 71 per cent, according to a data study.

A report by Deloitte Access Economics forecasts that the target population for the Commonwealth Home Support Program is expected to grow “at a relatively constant rate” over the next decade from nearly 4 million in 2017-18 to just over 5.4 million in 2028-29.

The number of clients requiring CHSP services is expected to grow from around 840,000 in 2018-19 to around 1.17 million by 2028-29.

The report was commissioned by the health department to inform policy development as Australia moves towards a new aged care system in line with the recommendations of the aged care royal commission.

“In November 2019 … the Australian Government announced its intention to establish a single unified system to support care for elderly in the home, which will replace the existing CHSP and HCP,” Deloitte says.

“This analysis highlights important areas of consideration for future reform.”

Clients and services

The report says 1,455 providers currently deliver 17 different types of service to more than 800,000 Australians under the CHSP.

Sixty-five per cent of current CHSP recipients are women and 32 per cent of CHSP clients are over 85, compared to 42 per cent of HCP.

Areas with relatively low socioeconomic conditions are associated with higher rates of CHSP.

The three most common service types are domestic assistance (330,000), allied health and therapy (245,000) and transport (175,000).

The report also found variations in services provided in rural, regional and urban areas.

Goods, equipment & AT, meals and transport tended to be recommended more in remote communities, while home maintenance and home modification was more common in urban areas.

Social support was more recommended in urban and remote communities than in regional areas.

Of the 1,458 providers funded to deliver CHSP services, eight per cent were for profit, 60 per cent were not for profit and 32 per cent were government.

NSW has the most providers (447) followed by Victoria and Queensland.

In 2018-19, $2.39 billion was allocated to providers under CHSP streams. Providers used $2.29 million leading to a funding surplus of $103.4 million.

Expenditure set to increase

Overall, Deloitte says expenditure on CHSP is estimated to grow 71 per cent over the next ten years, from $2.6 billion in 2018-19 to $4.5 billion in 2028-29.

Domestic assistance, meals and food services are expected to be some of the fastest growing service types.

Cottage respite, centre-based respite and flexible respite are expected to be the slowest.

However, Deloitte says further work is needed to understand the cost of CHSP service delivery.

The analysis found that most services got more funding than they needed, and most providers said their service delivery was less than they had planned.

“While most service types had a surplus of planned funding relative to the expended amount – with an overall surplus of 4 per cent recorded in 2018-19 – most service providers also reported an output deficit, on average 37 per cent, where delivered output was less than planned output,” the report says.

Unmet demand

However, eighteen per cent of CHSP providers  said they had unmet demand for one or more of their services, with domestic assistance the most commonly reported service with some level of unmet demand.

While most service providers required client contributions for their services, these contributions represented a relatively low proportion of the overall price of service delivery, the report says.

The average annual client contribution in 2018-19 was $252 per client.

The data also shows a wide variation in unit prices charged by providers and the unit price of services delivered was higher than the funded unit across all service types.

This could be because of a lack of consistency in reporting to the department, Deloitte suggests.

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