Inevitably, once the new Support at Home Program gets going – on 1 July 2025 but who knows! – CHSP providers will come across self-managed care. This currently exists as part of the HCCP and will continue once the two programs are merged. It is important for CHSP providers who are not at the same time HCPP providers to understand what self-managed care is about, and why it is such a big deal in HCCP.
The October 2022 discussion paper A New Program for In Home Aged Care sets out “five key areas of focus”.
- how to give older Australians the opportunity to manage their own services simply and easily should they choose to do so;
- how to best implement the desired clinical oversight and practical assistance through care partners for older Australians receiving care at home;
- how to fund providers to meet the full cost of care while achieving value for money across different service types, regions, and client cohorts;
- how to ensure the flexibility to respond to the changing needs of older Australians;
- how to foster innovation and future investment in in-home aged care.
Focus area 1 is exclusively about self-managed care, while focus areas 2 and 4 have a strong bearing on self-managed care. Focus area 2 and 4 implicitly ask the question: how to deal with clients who want to but can’t self-manage their care to a greater or lesser extent or not at all?
The reason why self-managed care looms so large in the October 2022 discussion paper, CPSA believes, is that the Department of Health and Aged Care could be misinterpreting what clients are really saying when they opt for self-managed care.
Another thing to note is that the call for self-managed care originates from the HCPP.
Why don’t we hear this call from the Commonwealth Home Support Program?
The answer, CPSA believes, is that when clients want, or say they want, to self-manage their care, they are complaining about the limited service they receive and the proportion of their HCP funds eaten up by care management and administration fees and charges.
There are no such complaints from CHSP clients (and no expression of the desire to self-manage their care) because they have no information about the funding which pays for their care.
In fact, CHSP providers may themselves not have costed out care management and administration on a per-client basis. Block-funding means that you don’t necessarily have to do that.
In part, HCP clients’ complaints about care management and administration fees and charges fall in a similar category as the observation often made about running shoes. The comment is that the manufacturing cost of a pair of top brand sneakers is only $10 while the retail price is $200. Apart from the likelihood that some HCP providers do overcharge for care management and administration, those two functions are important and do cost more than clients generally think they should cost. They see the sneakers manufactured for $10, but not the staggering cost of marketing and developing and maintaining distribution networks.
This lack of awareness on the part of HCP clients is in itself a reason why self-managed care might not be such a good idea. Obviously, a client who self-manages their care must have a good understanding of cost to enable them to make the right choices and not cut corners.
Incidentally, CPSA accepts that there are HCP clients who self-manage because that it what they want to do and who are competent to do this.
However, as mentioned focus areas 2 and 4 have a strong bearing on self-managed care. Our next post will deal with self-managed care in light of focus areas 2 and 4.