Aged care providers now have an additional four months to prepare for the rollout of the Australian Government’s Support at Home reforms, which will now commence on 1 November 2025.
While the extension offers some welcome breathing room, it is essential that providers use this time wisely. Now is the ideal moment to assess readiness, strengthen internal systems, and ensure your organisation is well-positioned to implement these significant sector-wide reforms.
To support providers in understanding the transition, the government has released a comprehensive manual titled “Support at Home Program Manual – A Guide for Registered Providers”. This manual has been revised to reflect ongoing developments. The latest Version, 3.0, was released in June 2025, offering the most up-to-date and practical information to support implementation.
The manual provides clear guidance on how registered providers can meet the rules, procedures, and obligations under the Support at Home program.
For NFP organisations preparing their accounting and compliance frameworks ahead of the new arrangements, the key areas of interest include:
- Review of the service list to ensure alignment with eligible services under Support at Home
- Service pricing and caps, including how providers can set prices within government defined limits
- Revised payment cycles and their implications for cash flow and reporting
- Grandfathering provisions for existing HCP clients and participant contributions
- Allocation and responsibilities of Care management under the new model.
Reviewing your Support at Home service list offering
The Support at Home program will replace the existing Home Care Packages (HCP) and Short-Term Restorative Care (STRC) programs. The new program has a defined service list outlining the funded services available to eligible participants.
Recommendation:
The government has issued a document outlining the services that participants can access under the Support at Home program. It’s recommended that your organisation review their service list offering in comparison to the Support at Home Service List to gain a full understanding of in-scope and out-of-scope activities.
Setting prices for your aged care services
Fair and transparent pricing is a core principle of the new Support at Home program. The initiative is designed to introduce capped pricing, ensuring greater consistency across service providers and preventing any inflated costs. At this stage, capped pricing will not be introduced until 1 July 2026.
Leading up to commencement, providers are required to communicate to existing participants and publish their prices for the services they deliver on the My Aged Care Service and Support Portal.
When setting prices, providers must ensure that the price reflects the full amount of revenue they will receive for delivering the service.
Unlike the current Home Care Packages (HCP) or Short-Term Restorative Care (STRC) programs, where separate charges for administration, travel, or care management could be applied, the Support at Home (SaH) program requires that all such costs be included within the unit price of the service itself.
This means providers will need to carefully calculate and consolidate:
- Service delivery costs
- Administration and operational overheads
- Travel and logistics expenses
- Any relevant care coordination components.
A clear, well-structured pricing model will be essential to ensure compliance, financial sustainability, and transparency under the new framework.
Recommendation:
Although the government has not yet finalised the pricing caps for Support at Home services, providers should not wait to begin planning. It is strongly recommended that your organisation fully cost its regular services now to understand the minimum viable pricing required for sustainable service delivery.
By identifying your true costs, including direct care, overheads, administration, and compliance-related expenses, you’ll be in a stronger position to:
- Align future pricing with government-set caps
- Avoid under-pricing services that may become financially unviable
- Justify your pricing strategy internally and externally
- Respond quickly when the official pricing framework is released.
Taking a proactive approach now ensures your organisation is financially prepared and operationally responsive when the final price limits are announced.
Payment Cycles and Provider Cash Flow
Under the new system, there are new rules for claiming. Providers must only claim for services on their service list that have been approved in the participant’s Notice of Decision and support plan at the agreed price. Payments are made on an arrears basis, and providers can determine the frequency of their claims, whether that is daily, weekly, fortnightly, monthly or quarterly. Claims can also be submitted individually or in bulk. Once the provider’s claim has been validated for payment, Services Australia will:
- Deduct the government funded amount and participant contribution amount from the participant’s budget
- Pay the provider the government funded amount.
Note: It is the provider’s responsibility to collect the participant’s contribution.
Successfully validated claims submitted online to Services Australia have a 7-day processing time between approval and payment being made. For ongoing services, providers have 60 days after the last day of the quarter to submit their claims. For short-term services, providers have 60 days after the completion of the episode to submit their claim for each participant.
Recommendation:
Providers should review several areas to ensure that their financial operations are aligned with the changes.
It is important to review and align your financial system or CRM to ensure it can:
- Track service delivery against approved participant plans
- Separate government funding and participant contributions
- Handle multiple claiming frequencies and formats
- Issue participant statements in the approved format, including all required information.*
You will also need to develop a cashflow management strategy which includes:
- Recognising any pressures on cash reserves or liquidity to account for arrears-based payments
- Adjusting your billing cycle, if required, to match the 7-day turnaround time for Service Australia payments.
Streamline your claiming processes to ensure that:
- Staff are trained on what a provider must submit for a successful claim. More guidance is found in the document titled ‘Support at Home User Guide – submitting claims to the Aged Care Provider Portal’. This can be found on the department’s website.
- Internal deadlines for submitting claims are set well within the 60-day window.
- You establish checks for your data before submitting to avoid any claim rejections.
Track your claim submissions and reconciliation by building a dashboard or report that will monitor:
- Claims submitted vs claim status
- Funds received vs what was expected
- Participant contributions outstanding.
*More information on participant statements can be found in the Support at Home Manual, and a Support at Home monthly statement template can be found on the department’s website.
The ‘Grandfathered’ provision on participant contributions & Unspent HCP Funds
A ‘no worse off’ principle applies to grandfathered Home Care Package care recipients. This applies to recipients who, on or before 12 September 2024, were either receiving a Home Care Package on the National Priority System or assessed as eligible for a package. The ‘no worse off’ principle applies to participant financial contributions.
The premise is that participants will make the same contributions or lower contributions than they would under the Home Care Package system, despite any reassessment into a higher Support at Home classification.
In practical terms for HCP recipients, this means that:
- Recipients who did not have to pay an income-tested fee – will continue not to have to contribute to Support at Home
- Recipients who paid an income tested fee – will pay the same amount or less under Support at Home as they did under Home Care Packages.
Transitioned HCP care recipients who have unspent funds at the commencement of Support at Home retain these funds for use under Support at Home. The prioritisation of claiming varies depending on the type of service being delivered.
When claiming regular or short-term services (e.g. Care services, restorative or end-of-life support), the following order will apply:
- The participant’s active Support at Home Budget
- Provider-held HCP Commonwealth unspent funds – funds that are transitioned with the participant and held by the provider
- HCP Commonwealth unspent funds in the Home Care Account – funds that are transitioned with the participant, administered, and held by Services Australia.
For Assistive Technology and Home Modifications (AT-HM), the claiming order is:
- Provider-held HCP Commonwealth unspent funds
- HCP Commonwealth unspent funds in the Home Care Account
- AT-HM funding tiers – these will be the pre-allocated funding levels depending on participant needs and eligibility.
Recommendation:
For any grandfathered HCP care participants, Services Australia will notify them and their provider of the contribution amount payable. As the provider, you will need to invoice the participant for their contribution through your CRM or accounting system.
Providers need to monitor the amount of HCP unspent funds transitioned to the participant to avoid overspending in the participant’s budget. Also, when Provider-held funds are used for service delivery, it is essential to ensure that the funds have already been paid to the provider.
Care Management Allocation to Providers
Another key difference between the Support at Home program and the programs it replaces is the approach to Care Management – both in terms of its scope and how it is funded.
Care Management refers to the ongoing coordination, planning, and monitoring of aged care services tailored to the needs, preferences, and goals of the participant. It ensures services are delivered safely, effectively, and in line with the participant’s support plan.
Under the Support at Home program, care management will be delivered by a designated staff member known as a care partner. These care management activities will be funded through the provider’s Care Management Account.
For participants receiving ongoing services, 10% of their quarterly support budget will be automatically allocated to care management. These contributions will be pooled with care management funds from other participants to form the provider’s collective Care Management Account, from which eligible care management activities can be drawn.
Activities that can be claimed by providers from their care management account are:
- Care planning – involves working with participants, their families, and support networks to identify individual needs, goals, and preferences and to develop tailored care plans, service agreements, and budgets.
- Service planning and management – involves the ongoing coordination and management of funded aged care services to ensure they are comprehensive, culturally appropriate and responsive to the participant’s needs.
Monitoring, review, and evaluation involve the ongoing assessment of the participant’s needs, goals, and care outcomes through regular communication, case conferencing, and evaluation.
Support and education involve empowering participants to make informed decisions, promoting wellness and reablement, and helping them navigate the aged care and health systems.
Recommendation:
Providers must ensure that their care partners understand the scope of care management. We recommend that you clearly distinguish between service delivery activities that form part of routine service delivery and those that are claimable under care management activities from the Care Management Account.
The transition to the Support at Home program brings significant changes that require careful planning and preparation by providers. If your organisation needs support in assessing the financial implications of the new program, Next Dimension Accounting is here to help. Our team has played a key role in guiding clients through the reform process and preparing them for what lies ahead.
For further information about Support at Home, get in touch with us today.
