A new discussion paper argues the case for mandatory HCP and CHSP contributions, saying this could help make the aged care system more sustainable.
Released by the University of Technology Sydney’s Ageing Research Collaborative, the discussion paper notes that the current aged care system is under stress and the situation is worsening.
Commissioned by peak body the Aged & Community Care Providers Association with the support of the Council on the Ageing Australia and National Seniors Australia, it’s hoped that the document’s release will spark an urgent conversation, the report’s co-author Dr Nicole Sutton says.
“We would like the paper to promote a frank, national policy debate on the sustainability of the aged care sector,” she told Australian Ageing Agenda.
The paper makes a raft of recommendations, including some specifically addressing the home care sector.
At present many providers don’t charge the basic daily fee, and in 2019-20 HCP recipients contributed only $102 million, or just three per cent of the total program expenditure.
The report says more clarity is needed about the role of the basic daily fee payable for home care, and argues that “from both equity and sustainability perspectives”, there is a case for having a mandatory, income tested consumer care contribution for both CHSP and HCP.
The introduction of the new unified support at home program offers a chance to mandate a voluntary contribution, the paper says, but the current plans lack clarity on this.
The authors would also like to see a more detailed classification system under the new program, so services can be better matched with needs.
Another way of improving long term sustainability of the aged care system is by supporting older people to maintain their health and independence, the paper says.
One way of doing this is to enable people purchase more non-subsidised top-up-services to help them age in place,
“Further investigation is warranted to understand the nature of the current and potential markets for non-subsidised aged care-related services and accommodation settings, and how they may be combined with services that are subsidised and regulated by the government.”
The report also recommends boosting the role of Nurse Practitioners and primary health networks in aged care, providing more restorative and transition services, improving palliative care, and supporting carers – including via subsidised respite care.
Spending to grow
The paper says government expenditure on aged care this year is expected to be $27 billion, or 1.2 per cent of GDP, growing to 2.1 per cent of GDP by 2060-61.
It warns that government forward estimates of aged care spending fails to take in several factors, including the growth of Home Care Packages beyond 2023 to address the ‘bulge’ in ageing baby boomers.
Against this outlook, data for HCP providers shows a tightening of financial performance in recent years. Prior to 2017, providers typically earned $3,000 a year per customer. That’s dropped to $1,369 in 2019–20.
Data from the first six months of the 2021–22 financial year show that the operating result of home care services has declined by 25.5 per cent compared to the same period a year ago.
The paper puts the recent decline in profitability down to a plateauing of revenue while costs have increased, particularly around care management, advisory administration and support.