In preparing for the roll-out of consumer directed care, some of the first and most significant work happened in transforming our business model, writes Neil Fawcett.
The introduction of consumer directed care (CDC) has required a total rethink of our organisation’s service model. After a significant amount of consultation with clients and their families, we realised that while CDC brought with it the option for greater control for clients, it didn’t necessarily mean all clients wanted to take full control over their package.
As a result, we created three levels of package service:
- Fully supported
In our opinion, this was what CDC was all about: giving clients the choice on how much control they wanted to have, rather than expecting everyone to want fully self-managed packages.
To support the new model we needed to develop fee structures for each level of service. In doing so, we needed to consider what the client would be prepared to pay but also to be competitively priced in the market.
As part of this, it was critical that we clearly articulated to our clients and staff how many hours were available under the different types of package service. And it was equally important that we developed tools to track the hours used and be able to charge clients who used more than the allotted hours under the package they had chosen.
Whilst we can’t truly know the full impact of CDC yet, we have started to get some indication. Since beginning the process of moving package funding and client expenses into the balance sheet, we’ve already seen it impact our financial performance. The transition has highlighted inefficiencies that exist in our current staffing structures.
Shifting to user pays
Another challenge that we needed to plan for financially was the potential impact of the move to a ‘user pays’ system. Home care reform has seen the introduction of concepts such as co-contributions and income-tested fees, and with this comes added complexity.
As a not-for-profit aged care provider, we needed to be mindful that this system was being introduced to a cohort that had never been asked to make a financial contribution towards the services they received as part of a package. We identified that this shift was inherently going to bring with it challenges, based on the fact that it was new.
This challenge is made even more complex by many people still subscribing to the theory that it’s the government’s responsibility to provide care and support to people as they age. While there is nothing wrong with this argument, the reality is that this isn’t how things operate anymore. It has become our responsibility, particularly as a not-for-profit provider, to re-educate our service users.
So how did we do this?
We relied heavily on upskilling our Benetas Customer Centre staff and equipping them with the knowledge they needed about the reforms, to appropriately support clients, future clients, families and staff.
In addition to providing aged care advice, the customer centre is a central admission point for Benetas clients and for this reason plays a significant part in outlining client responsibilities around payment.
Supporting staff to change their thinking
Education from the customer centre needed to be reinforced by the messages given by our staff. We needed to encourage our staff, particularly managers, to think more commercially and to act quickly when fees go unpaid.
This has and will continue to require a huge cultural shift for staff. We are finding that some staff are making the transition, but others are finding it more difficult.
As a not-for-profit, this has come with its challenges. Our program staff are a dedicated group, who have been drawn to working for a not-for-profit organisation for a reason. Supporting staff to adjust their mindset and behaviours has involved respecting their values, and upholding those of the organisation, while retraining them in setting fees, creating budgets and having financial conversations with clients.
We’ve had to stay consistent with our messaging, in that despite being a not-for-profit, we are not prepared to accept significant loss or debt. We need to deliver a sustainable business.
With the major financial challenges addressed, our focus now moves to how we can invest in information technology to better serve our customers under the new model. We’re committed to using new technologies to deliver better client outcomes and an improved customer experience.
For Benetas, this includes an $8 million investment over five years into our current finance, residential care and home care IT solutions, as well as implementing a client resource management solution to support the work of our customer centre.
We’ve just started transitioning our home care clients to our CDC online client portal, MyBenetas. The portal provides clients with greater access to their statements, also giving them the ability to change the type and frequency of the services they receive from us. This will join the suite of initiatives we have already rolled out to support the implementation of reforms across the business.
We know the journey to CDC in some ways is only just beginning, and it’s not certain what exactly the future will hold or what the impacts might be. What we do know, however, is that with proper planning across all areas of the business, the introduction of the ‘new world order’ gives businesses the opportunity to not just react, but innovate, transform and grow.
Neil Fawcett is chief financial officer with Benetas.
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