A mixed funding model is proposed to balance consumer choice and provider certainty.
Consumers receive a quarterly budget
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Consumers would receive a budget based on their assessment outcome.
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The budget is reset quarterly, with no savings between quarters
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eg a person may have a budget of $2,000 per quarter and if they only spend $1,500 on services in the first quarter, their budget in the second quarter remains at $2,000.
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Clients will agree an affordable set of ongoing services at assessment but may change services within their budget at any time.
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Clients have full choice over services within the following bounds:
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Services must be on an ongoing services list
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There will be caps on the level of cleaning and gardening that can be accessed per quarter.
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Complex clients with a budget for a care partner can not trade off this service for other services.
Provider Funding Element
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How it would work
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Activity based funding
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Providers bill for services on a service list and can only price up to the list price set by government on advice of IHACPA.
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Prices include a mark-up for administrative and travel costs
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Services are billed against client budgets (or a flexible funding pool – see below)
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Invoices may be submitted monthly or more frequently to Services Australia
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Supplementary grants by service type
(transport, cottage & centre-based respite, meals, social support group)
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Existing CHSP providers delivering these service types would receive a funding guarantee set at 80% of their current grant value
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If monthly activity based payments fall short of the funding guarantee, they will receive an automatic top-up payment to the guarantee.
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These providers will be able to plan with funding certainty while receiving full activity based payments for any service expansion for new clients.
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Supplementary grants for high cost or low volume
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Providers, such as those operating in rural and remote locations or with diversity groups, for whom activity based payments would be insufficient may bid for long term supplementary grant funding.
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Grants would be part of their ongoing funding model on 3-5 year agreements.
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Funding pool
for additional temporary client services
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Providers will be able to deliver extra services to clients (above their budget) when they have temporary needs – eg after a fall or when a carer is away
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This will be paid as activity based payments billed against a flexible funding pool
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Each provider will have access to a flexible funding pool set at 25% of their total client budgets – eg a provider with client budgets of $100,000 could bill up to an extra $25,000 to provide extra supports
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Providers would determine how to allocate this fund across clients within guidelines
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This approach may also be used for episodic care management services.
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Consulting on alternative model in thin markets and First Nations Model
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The Department is consulting with First Nations providers and Elders on options for a different grant-funded delivery model based on the NATSIFACP approach in remote Australia.
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This would provide more flexibility to providers to adjust services over time to meet client needs, while offering more funding certainty to attract more Indigenous controlled organisations into aged care.
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For further reading and information In-Home Aged Care Resources