There are several different approaches to CDC home care provision evident in the aged care marketplace. Here we explore the characteristics of 6 of the most common:
1. The Jobs & Care Approach
Prior to deregulation, organisations were able to tender for home care packages, and were not required to disclose financial statements to their home care clients. Successful tenders meant organisations could effectively get substantial recurring funding to employ who they like and care for eligible clients at their discretion. Ethnic and religious based organisations management and Board committees saw home care funding as very aligned to employing their ‘members’ to care for their ‘members’. With “jobs” having priority alongside care, innovation and efficiency initiatives could be stifled, as such initiatives would make administrative and managerial roles redundant. The jobs and care approach is a dying structure as home care deregulation changes have pushed organisations to focus on the care not jobs, and putting control to the home care recipient. However, success is coming out of the sector especially with ethnic organisations who have switched to focus on care and excellence in cultural servicing certain niches, even, growing their business to support other businesses support their home care clients fitting their strengths.
2. The Brokerage Approach
The brokerage approach comprises organisations who have found themselves looking after clients of various diverse needs with motivations not necessarily based in home care. Examples include migrant support, regional community organisations and generally providers who do not see themselves as carers, rather consultants, case managers and support coordinators. The organisations have found themselves as the trusted adviser and for various reasons, have determined that other direct care organisations are better placed to service the diverse set of needs of their client’s, better than any internal workforce they might have. These organisations’ have stuck with more of an advisory, consultative role, being first point of contact for their clients’ and effectively ensuring they are serviced with a care packaged totally consumer directed to best of breed services. Many existing home care players are increasingly switching to this approach as its effectively enshrined in the consumer directed legislation, in that their direct care businesses struggle with viability when benchmarked against other price competitive direct care organisations.
3. The In-House Approach
Many traditional home care providers have come from a residential care background and on the back of national home care funding starting almost 20 years ago, have expanded into sizable direct home care workforces. Further reinforcing this home care workforce would be cultural and brand motivations to ensuring their care is completely vertically integrated and 100% in house to ensure quality consistency with their brand values. All the major care management and rostering systems have evolved around the in-house approach, making large administrative efficiencies also incentivising in-house services, as data entry is avoided in complying with today’s client statement requirements. It is not uncommon for customers to be charged a surcharge such as 10%, on services that come from external providers, to cover the additional administrative and quality assurance requirements for using non- in-house services with these providers. The in-house model is breaking down as care recipients increasing become aware of their rights to choose and exercise these rights for reasons of price and preference.
4. The ‘we are already the carers’ Approach
With portability of home care packages introduced in 2017, it’s only natural that home care recipients are going to want to stay with services providers they already know or at least get encouraged to join service providers they already know. Many direct care providers that previously brokered to approved providers, are registering as an approved provider and taking on the whole care management package as they see themselves as the major carers anyway. Other operators, such as retirement village operators are doing the same thing. They already have a significant commercial relationship with the residents in their village, and they see themselves as the natural provider of care services management, and their customers are transferring their packages to them.
5. The Self – managed Approach
There is another emerging segment of home care recipients who are looking for the best value (lowest management fees) with control demands that effectively eliminate the need for a case manager. Existing operators have already been pressured to offer these ‘no frills’ home care packages and home care operators are emerging to specifically address this segment. The demand from home care recipients and capability for approved providers to offer this, while staying responsible, per the Aged Care Act for the well being of the home care recipient’s and their carers is still to be established. Currently COTA (Council of The Aging) has been funded by the government to look into the demand and methodologies for self-managed home care, results expected in 2019.
6. The Funding Driven Approach
There are a number of organisations, generally focused on a special needs group or in a regional area, whose main mission is to look after these individuals, whatever it takes. These organisations are skilled at supporting their clients and generally juggle funding from many sources, including obtaining home care funding where their client is eligible and obtain a home care package. These organisations are usually quite visible as they generally only have under ten packages, regularly between one and three packages.