Pricing Transparency to Impact Aged Care Service Providers

From 1 July 2019 Commonwealth funded residential care, homecare and flexible care providers will be bound by two new legislative principles;

The Quality of Care Amendment (Single Quality Framework) Principles 2018 (Cth) and;

The User Rights Principles 2014 (Cth) relating to pricing transparency.


The new obligations mean approved providers of Commonwealth funded aged care will be;

(1)   Assessed against a new set of Aged Care Quality Standards (Single Quality Framework);

(2)   Mandated to adhere to new Pricing Transparency requirements for Commonwealth Funded Home Care Services.


Here’s what you need to know:

The Quality of Care Amendment (Single Quality Framework) Principles 2018 

In summary, the amended Quality of Care legislation will introduce a new set of Aged Care Quality Standards which will apply to approved providers of Commonwealth funded residential care, home care and short-term restorative care.


Importantly, you the approved provider will be assessed against the new Quality Standards and must be able to provide evidence of their compliance with the Quality Standards from 1 July 2019.


What are the new Quality Standards and what does this mean for you the provider?

Approved providers will be aware that at present, there are 4 sets of quality standards depending on the type of aged care service being delivered. These are the:

  •  Accreditation Standards; (which apply to residential aged care services and some forms of flexible care);
  • Home Care Standards; (which apply to home care services, Commonwealth Home Support Program services, and some forms of flexible care);
  • National Aboriginal and Torres Strait Islander Flexible Aged Care Program Care Standards; and
  • Transition Care Standards (which apply to short term restorative care).


The purpose of the new Bill is to introduce a single set of aged care standards which will apply to all approved providers and focus on outcomes for consumers; increase consistency across the sector and encourage approved providers to offer services that promote quality of life and wellbeing.


The new Single Quality Standards are comprised of 8 individual standards being:

  1.  Consumer dignity and choice
  2. Ongoing assessment and planning with consumers
  3. Personal care and clinical care
  4. Services and supports for daily living
  5. Organisation’s service environment
  6. Feedback and complaints
  7. Human resources
  8. Organisational governance


In short, each of the Quality Standards is expressed in three different ways being:

  • A statement of outcome for the consumer
  • A statement of expectation for the organisation and;
  • Organisational requirements to demonstrate that the standard has been met.


We recommend that you update your systems, policies and practices to align with the new Quality Standards module to ensure compliance by 1 July 2019. 


Pricing Transparency Requirements For Commonwealth Funded Home Care Services.


Under the amended User Rights Principles 2014 (Cth) legislation, aged care providers will be required to publish the prices of a number of common services found in home care packages, including personal care, nursing, cleaning, light gardening and care management.


The purpose of the new legislation is to make it easier for home care recipients to understand and compare costs. For example, providers will be required to list the amount of the ‘basic daily fee’ (currently set at a maximum of 17.5% of the pension), that consumers have to pay as a co-contribution for their home care package.


Under the phased introduction, home care service providers will be required to provide this information for new clients from 1 July 2019, and for existing clients, before 1 July 2020. The phased approach ensures home care providers have adequate time to adjust to the changes and undertake necessary transition activities.


In short, you will need to nominate a single price they charges prospective and current care recipients for each of the following services:

  • personal care
  • nursing by a registered nurses
  • cleaning and household tasks
  • light gardening
  • in-home respite care
  • care management
  • any per kilometre costs for travel to a care recipient for the purpose of providing care or services
  • any costs related to providing care or services through a subcontracting arrangement where necessary to give effect to a request by a care recipient
  • any package management costs
  • any Basic Daily Care Fee
  • any daily home care fee.


Where you the provider offer genuine client choice of different prices for a service, they will also be able to enter the minimum and maximum price points. This may be where an approved home care service provider arranges services via sub-contracting arrangements and therefore can offer their clients different prices for a service.


The biggest change for most home care providers is that under the new legislation, providers are no longer able to charge separately for business-related administration costs. These costs, such as office rent, insurance and marketing, will need to be included within the scheduled price for care and services. In other words, all administration charges and subcontracting costs are to be rolled into consolidated service prices, rather than being applied as separate and additional charges.

You the Provider will still be able to publish their prices for package management within the Schedule. Package management includes activities that are directly related to managing your Home Care Package. These include preparing monthly statements, managing your package funds, and compliance and quality assurance activities required for home care.


Providers are encouraged to start publishing information in the new Schedule as soon as possible as the first stage of compliance is required from 1 July 2019.


For more information regarding compliance, providers talk with eziplan for the Home Care Pricing: Readiness Checklist for Home Care contact us today