Opportunities under new legislation
The new Aged Care Act and Support at Home program offer plenty of reasons for providers to pick up their game on reablement, say Positive Ageing Summit speakers.
As Bolton Clarke chief executive officer Stephen Muggleton put it, “increased longevity can also lead to an expansion of morbidity.”
It means, without intervention, future older Australians will spend more time managing several chronic health conditions and associated increased frailty than living well. But as he also pointed out, “it doesn’t have to be” this way.
Jason Skennerton – head of business development at allied health service Plena Healthcare – calls on both residential and home aged care providers “to flip the script” on allied health by adopting a wellness and reablement-first approach.
“This approach means focusing on using health and wellness experts to prevent health deterioration and increase independence, rather than engaging as a reaction to an incident,” Skennerton told AAA.
Incoming legislation offers providers opportunities to make it worthwhile, said Skennerton. In residential aged care, this includes a new focus on reablement, increased accountability for quality and residents’ rights.
“The Act focuses on reablement and restorative care, which makes allied health a key requirement and expectation for residents. This opens the door for more preventative and proactive allied health services under the Higher Everyday Living Fee additional services and from providers, rather than the old reactive measures,” he said.
HELF allows providers to offer and charge for enhanced wellness and lifestyle services as part of an opt-in premium resident experience.
“This enables providers to generate an additional revenue stream that helps offset allied health costs while maintaining high-quality, proactive care,” he said.
With the new quality standards focusing on measurable allied health outcomes, consistent allied health data can help providers meet compliance, added Skennerton.
“Aged care providers will be expected to tailor care around a resident’s goals. Allied health [professionals and providers] can support with assessments and interventions aligned with personal independence and wellness goals.”
While some elements of Support at Home are questionable, one shining positive has been the increased focus on wellness, reablement and clinical services.”
For older people living at home and home care providers, the Support at Home Program presents a large shift in how aged care supports are delivered, said Skennerton.
“While some elements of Support at Home are questionable, one shining positive has been the increased focus on wellness, reablement and clinical services,” he said.
“The program ensures a with-you approach rather than [a] for-you approach is adopted to ensure health, wellness and true independence is always front of mind.
“The strengthened standards, in particular Standard Five, further reinforce the need for providers to have strong clinical frameworks in place that focus on early identification of clinical risk, prevention and reablement.”
Dr Tim Henwood – principal at AgeFIT Solutions – said the SaH program manual’s focus on reablement shows the Australian Government acknowledges the value of an increased allied health and therapy offering by aged care sector.
“Providers not already pivoting or at least thinking about pivoting towards allied health and therapy stand the chance of being left behind,” he told AAA.
“And unless providers are prepared to challenge the usual, historic model of care, the sector will be racing towards an aged care and healthcare crisis.”
The terms reablement and wellness have also experienced a significant increase in the quality standards manual and guidance material, added Henwood.
“As further reinforcement of how much the government realises the benefit, we are about to see a dedicated reporting stream for residential aged care allied health and therapy within the quality indicators, and allied health and therapy will be one of only two direct service types fully funded by the government, with no out-of-pocket to the client in Support at Home.”
It’s a big change, he points out, because allied health, reablement, and wellness have traditionally been offered secondary to care and often less than evidence based.
And while some are making allied health and therapy service available to clients because they know it is valuable, they are doing it at a financial loss, said Henwood.
“However, there are already several successful and sustainable operating models out there that demonstrate this doesn’t need to be the case.”
In home care, Skennerton said new quarterly budgets, capping of unspent funds and care management fees, increasing client contributions, plus wellness and reablement requirements, make an increase in preventative-focused clinical services beneficial for both clients and providers.
“Clients receive more services that improve their functional capacity and independence, providers ensure budget utilisation is strong,” which he said “will be key for home care providers to remain viable in the space” and “participants receive less out of pocket costs.”
Rather than home care providers continuing to rely on subcontracting to support clinical service delivery, Skennerton predicts partnership models at scale will become a crucial element of the SaH program to reduce risks. Doing so, he said, will benefit home care providers with:
- high quality and consistent service delivery standards
- better control of service delivery margins within a price cap environment
- alignment to wellness and reablement requirements
- integrated multidisciplinary care.
“Strong leadership and sector-wide support are essential to embedding these approaches into aged care services.”
Overcoming adoption barriers
Dr Claire Gough – research fellow at Aged Care Research & Industry Innovation Australia – said the world-leading Restorative Care Guidelines being developed by the Department of Health, Disablity and Ageing will provide a clear framework for providers and support older people in maintaining their independence.
To overcome current barriers to embedding reablement and restorative care,aged careproviders need to recognise the long-term benefits in improving the independence and wellbeing of older people and in potentially reducing long-term care demands, she said.
“Strong leadership and sector-wide support are essential to embedding these approaches into aged care services,” Gough told AAA.
Improving awareness and understanding of what reablement and restorative care involve is another key step, she said.
“Clearly distinguishing these approaches from traditional care models will help providers, health professionals, carers, and individuals receiving care recognise their benefits and adopt them more effectively.
“For those receiving care, setting clear expectations about the importance of active participation is crucial. Ensuring individuals understand that reablement and restorative care focus on maintaining or regaining independence – rather than simply receiving assistance – will encourage engagement and lead to better outcomes.
“Additionally, embedding education and training for providers and carers, along with leadership support and practical resources, will further strengthen the adoption of these approaches across the aged care sector,” said Gough.
Positive Ageing Summit is an initiative of Australian Ageing Agenda and Community Care Review – read our coverage of the event here and find out more on the Positive Ageing Summit 2025 website
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