A Letter to the Minister
Provider Feedback on the Support at Home Reform
5 minute read
To: The Hon Sam Rae MP, Minister for Aged Care
Date: 11 December 2025
From: Invox, representing frontline provider perspectives on the Support at Home reform
Re: Insights from QANDA regarding the Support at Home rollout
Dear Minister
Thank you for inviting feedback on the implementation of the Support at Home reforms. To support this, Invox sought input from providers through our QANDA forum, where people working in the sector have been sharing questions, concerns and early experiences of the rollout.
Across these posts, a consistent picture is forming: while the sector is committed to making the reform succeed, significant issues are appearing early. These range from concerns about assessment outcomes and rural access, to co-contributions, system mismatches and the likelihood of an escalating review backlog. Providers are signalling that these pressures require attention now to avoid unintended impacts on older Australians.
The following summary reflects the key issues providers are raising in these early weeks of implementation.
1. “No worse off” is becoming harder to deliver in practice
The promise that older people already on packages would not be worse off under SaH is already proving very difficult to uphold. With the changes to co-contributions, clients who rely on short, essential visits to stay independent are being asked to reduce services or contribute more than they can comfortably afford. Remote communities are feeling this most, with the loss of regional loadings making service delivery challenging for many providers.
Hourly rates are rising to plug structural holes and high-utilisation clients (many with complex needs) are at risk of losing the care they’ve relied on for years. Reassessment is held up as the fix, but on the ground it means long waits, shifting rules, unpredictable outcomes and fear about what happens to people in the meantime.
Yes, the no worse off principle was very specific in the governments eyes, but whether you like it or not, you sold it as something that meant much more.
2. Confidence in the assessment algorithm is wavering
A recurring theme on QANDA echoes what we outlined in our recent Serious Assessment Wobbles article: the new assessment system isn’t yet working the way it should. Assessors are finding themselves working with an algorithm that can deliver outcomes they can’t easily explain and in many cases, can’t adjust even when their clinical judgement points in a different direction.
There are also reports of comprehensive assessments resulting in CHSP-only or even ineligible determinations that feel very out of step with what was observed in the home. These issues are signs of a system that is not finding its feet and an assessment engine that is failing to build confidence in its outcomes.
Please spare us the senate enquiry line of ‘only 19 cases have been formally requested for review’ and rest assured a storm is brewing and it won’t be in a teacup.
3. The reform is costing far more than government acknowledges
Providers are crystal clear: the $10,000 transition grant barely scratches the surface. Our view is it’s embarrassing.
They are absorbing major unfunded costs across their workforce, systems, IT, admin capacity and compliance work. All while also being expected to maintain quality and continuity of care.
Frontline teams are being stretched to breaking point because there is simply no funding to resource the change properly. Adding insult to injury, providers see government’s own IT project running over time and over budget while they are told to “make do”.
Providers are asking for honesty about the cost of reform and a genuine partnership in delivering it.
4. There are growing challenges delivering SaH in rural and remote regions
Rural and remote communities are feeling the strain of the transition. In several regions, providers are reporting exactly the scenario they had been concerned about: CHSP-only organisations finding that no SaH providers are currently accepting new referrals in their shire. With travel costs high and the SaH pricing structure difficult to apply across long distances, some providers feel unable to take on out-of-town clients.
This is leading to a growing number of older people with active SaH approvals but no available provider to support them. It’s an emerging pattern rather that suggests that these communities require additional attention and tailored solutions to ensure they are not left without viable service options. These communities need block funding that guarantees services will be available when needed.
5. Co-contributions are creating financial hardship, even for people at the end of life
Some of the most distressing posts on QANDA relate to co-contributions.
Full pensioners on transitioned packages are suddenly being hit with 5% + 17.5% contributions, even when they have unspent funds available. Providers report cases of clients in end-of-life care at home being unable to afford the daily supports they need because the contribution rules make no allowances for terminal illness or financial hardship.
And, the sector’s position is clear, if a person is dying at home and cannot pay the co-contribution, there must be a mechanism to waive it. It remains to be seen whether the hardship application process through Services Australia will be sufficient or timely enough.
6. Conflicting system data is causing delays, disputes, and confusion
Providers are finding that the system is contradicting itself.
Medium-priority clients suddenly appear as standard in My Aged Care.
Assessment findings don’t match what the MAC system displays.
The AT-HM list contradicts the Reference Data with no guidance on which source is correct.
These mismatches aren’t minor administrative errors, they create more work, more disputes and more delays at exactly the moment the system needs to be stable and consistent.
7. Support Plan reviews will become the next major backlog
With no ability to override the algorithm, assessors are urging providers to lodge Support Plan Reviews for inappropriate outcomes. But this is not a solution, it’s a major problem looming.
SPRs will rapidly become a second queue, drawing assessor time away from clinical work, clogging the system, and delaying services further. Several assessors have already warned on QANDA that they expect to be “flooded” with SPRs by early 2026.
8. Interim funding for new packages.
93% of new SaH packages are being released as interim packages, funded at 60% of the value of their SaH classification. This transfers risk onto providers and older people, as quality standards remain mandatory. Apparently participants could remain on this interim funding for up to 17 weeks.
Priority Actions Identified by Providers
Minister Rae, the sector wants you and SaH to succeed. It is clear that this reform cannot work without urgent course correction.
On QANDA, providers have been remarkably constructive. They are not simply complaining; they are diagnosing, documenting and offering solutions. What they are asking for is entirely reasonable:
Clinical override pathways - a simple, safe mechanism for assessors to correct outcomes when the algorithm hasn’t got it right.
A trustworthy, transparent algorithm - one that clinicians and providers can understand, rely on, and explain to families.
Funding for transitioning clients that matches their established needs - so people don’t lose essential supports during the shift to SaH.
Relief on participant contributions for people genuinely unable to pay - especially where essential or end-of-life care is involved.
Secure the viability of rural and remote services - making sure distance and travel pressures don’t restrict access.
Clear, consistent system data - with MAC, assessment outputs and reference lists aligning rather than contradicting one another.
Transitional funding that acknowledges real-world costs - covering workforce, IT and change management rather than relying on providers to absorb it.
Meaningful partnership between government and providers - with open feedback loops and transparent problem-solving, not last-minute adjustments.
This reform will shape the next decade of aged care and providers want to help make it work. But they cannot do it alone and they cannot do it under current conditions.
The signals are clear. QANDA is full of them. The question now is whether the system can adjust early enough to ensure older people receive the support the reform was intended to deliver.
Sincerely
Invox, representing frontline provider perspectives on the Support at Home reform
* Invox QANDA
Invox QANDA is a free hub where 2,000+ people are getting real-time answers to emerging SaH questions - https://www.invox.com.au/invox-qanda
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