Home care package providers have significantly improved the accuracy and clarity of their pricing information on the My Aged Care website, according to a government review.
The report – published 3 October by the Department of Health and Aged Care – is a follow-up to phase one of the Pricing Transparency on My Aged Care review published last year.
The review’s purpose was to assure providers’ pricing information on My Aged Care was “complete, accurate and current”, and adhering to the Aged Care Act 1997.
Sampling data uploaded by 839 home care providers, phase one of the review discovered a large majority displaying “insufficient pricing transparency”.
Among the problems identified:
- price lists missing or incomplete
- inconsistent advertising of prices
- incorrect subcontracting charges.
“The [August 2022] review report identified assurance of pricing transparency as a priority,” write the authors of the latest report.
Home care consultant Anna Millicer told Australian Ageing Agenda that providers routinely failed to meet government guidelines. “A very large proportion of providers at the start of the review process were not meeting legislative and program requirements. That’s a problem – that’s a big deal.”
Phase two of the review into pricing transparency has found a “significant improvement in the accuracy, currency, clarity and completeness of pricing information on My Aged Care,” write the report’s authors.
However, Ms Millicer – founder of Get Smart Aged Care Consultancy and the Home Care HQ newsletter service – told AAA: “There was – and still is – a lack of understanding of the nuances around [providers’] own pricing.”
The latest report seeks to remedy this by detailing the requirements providers have to meet and outlining the steps they have to take.
“Providers don’t necessarily know where to look to get the right sort of information, and this report hands it to them beautifully,” said Ms Millicer. “This report is very, very instructional. It’s telling them here’s what you need to know and here’s what you need to do to get your house in order. They’re able to use these learnings from the report in a really practical way.”
Unspent funds
The department dropped another report on 3 October revealing the findings of a government review into unspent funds.
“Departmental data shows that as at May 2023 there was around $2.8 billion of HCP unspent funds, with around $700 million held by providers and $2.1 billion held by Services Australia. The majority of the $700 million held by providers is the Commonwealth portion,” reads the report.
“It’s telling us that there are still potentially unmet needs for consumers, because if providers’ unspent funds are going up, then that’s money not being spent on the direct care and service delivery for consumers,” said Ms Millicer. “We know that providers are still taking their package management and care management fees – that’s a given – so why are unspent funds still going up?”
Ms Millicer told AAA that the review’s findings will be seen as a red flag. “The department is concerned that consumers needs are not being adequately identified through the process of assessment and annual review and, consequently, the consumers needs are not being adequately met.”
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Unspent funds are going up because so many are on a higher package than they need to be. If they’re not spending it, they don’t need it. This is a fatal flaw in the system of assigning HCP’s and auto upgrades and not being able to go down a level if current needs have changed/reduced. . It is so infuriating that the blame is laid on the Case manager and their supposed poor practice in terms of assessment & care planning. It’s Also Ageist to assume the HCP recipient is unable to identify their own needs and speak out for support.
The other major impact on spending is the lack of direct care workers across the sector. Can’t spend funds on services if there’s no workers. Also additional exclusions added to the guidelines earlier this year that cut off a lot of spending that was basically using the package as an additional income source.
This “expert” shows limited understanding of the sector on the ground.
I agree with Margaret. Easier to blame providers but I’ve worked in a HCP environment where clients refuse to use their funds as a way of holding them for some future need. Also we have a problem where people are not re-assessed. Unspent funds suggest many things but also that a person may have been inappropriately assessed at a higher package level. There’s no easy answer but I think the package should not cover things deemed regular house maintenance (mould) or things that people could normally buy eg heater. However, it’s such a grey area as someone living in public housing may have fewer resources than someone living in non-public housing.
We live with the constant tension between types of needs and prioritisation of support. We certainly need better messaging by Government through its many pathways about the purpose of HCPs and priority of servicing.
Totally agree Margaret. The last time this topic came up I commented the exact same sentiments as yourself. I don’t think anyone is listening to those on the ground, who on a daily basis work face to face with their clients. It’s about ‘choice’, they either want more services or they don’t. We don’t assign package levels, very hard to utilise surplus when assigned L4 and only requires minimal assistance and vice versa.
Unfortunately the CDC model did not fulfil its requirements. The large amounts of unspent funds highlights that assessments are not in line with needs. The model does not allow flexibility with other hcp clients that have insufficient funds and cannot increase their services which would allow them to remain at home. The past program CACP, EACH, the provider was able to meet the needs of every client by utilizing unspent funds for those that needed more. The use of hcp funds to buy equipment etc should not have been implemented as such because all recipients want to buy what they want and do not want to understand the exclusions. Again, in the past there was a set amount of funds that a person on CACP and EACH was able to use on equipment etc. With the increased rate of pay for care staff there does not seem to be a problem in finding staff so the issue is not about staff shortages. On many occasions we have family members asking for the unspent funds as they are assuming is part of their family member’s estate. This is explained on many occasions but again they prefer not to understand.
Totally agree Margaret. There is no facility for recipients to drop down a level and do for clients who have re enabled, often due to exceptional case management and care, they may have gone from a level 4 to a level 2 and be living a mostly independent life. This happens post a significant illness or event often and it is client directed care. Blaming providers and coordinators for such events is futile and counterproductive. Providers should have the capacity to initiate reduced levels of funding or at the very least a reassessment for this to happen. Let’s hope Support at Home will address this.