Home care packages to increase 51% by 2017 says Deloitte
18 June 2015: Professional services firm Deloitte has released a whitepaper ‘How consumer driven care is reshaping the community care sector’ which explores the regulatory reform being introduced through the National Disability Insurance Scheme (NDIS) with its emphasis on choice and control, and Consumer Directed Care (CDC) being introduced in aged care reforms. CDC will be implemented by July 2015 and the number of home care packages will increase from 2017 onwards.
“Disability and aged care services will be transformed, giving customers greater control of services delivered. The total number of home care packages in 2013 was 66,000 and will increase to around 100,000 by 2017 - an increase of 51.5%,” said Lynne Pezzullo, Deloitte Access Economics partner leading health and social policy.
The move to person centred care is the "genie out of the bottle" for all care services across Australia. For too long, Australian citizens have been provided services at the convenience of service providers.
“Changes in both disability and aged care have heralded the dawn of a new era. Citizens expectations of being in control of their wellbeing and selecting services that are valuable to them is growing, so it is only a matter of time before the bastion of healthcare is also challenged,” said Ms Pezzullo.
Deloitte interviewed a number of service providers in aged care, community care and general healthcare and grouped its findings into six themes:
Emphasis on customer centricity
The NDIS and CDC will provide consumers of disability and aged care services with more choice about the types of services and the delivery of those services.
Jovita Gartlan, Deloitte Consulting partner, believes buying behaviour will change with many consumers demanding access to a workforce with specific cultural, linguistic and technical skills.
“Consumers will demand softer skills from support workers and there will be a greater emphasis on communication and attentiveness to individual’s needs. This may lead to a greater variety of more specialised services.”
Private providers may selectively provide more profitable services whilst turning away the challenging non-profitable cases. Policy will need to carefully address potential gaps and equity issues, while also managing potential consolidation in the sector arising from corporatisation.
Higher customer demand may lead to workforce shortages
There will likely be a shortfall in the supply of nursing capacity, which may lead to increased pressure on hourly wages or the use of alternative models of care wherever possible.
“Customers with less complex needs will be cared for by community care providers as opposed to more highly trained nurses,” said Ms Gartlan. “It will be about retaining good staff with particular skills in the aged and disability care environment.”
NDIS has under-priced particular activities and services
Prices in these cases will likely increase to ensure a competitive environment exists to service customers.
Providers will need to re-configure their existing processes and systems
Existing providers will need to review their cost structures as the move to an activity-based costing (fee for service) approach becomes the norm. This will lead to a review of cost structures, transparency and business processes.
“Without surety of income or demand for services, providers will either consolidate in the market or demand fee for service structures with their suppliers. This may include staffing models. For the most innovative, we may see a move to a crowd sourcing type model whereby available workers select how and when they want to work on a real time basis and/or that additional capacity is sold on the open market,” said Ms Gartlan.
Ability to sub-contract services to a registered or un-registered environment
In this new world where the consumer has ultimate choice, some service providers in extreme cases, could be sub-contracting with multiple service delivery providers to deliver the range of requested services. Managing sub-contractors may become difficult and not a core skill the providers actually have.
“The onus will be placed on the providers to ensure appropriate checks are undertaken and appropriate care provided. This raises concern regarding the levels of administrative costs that may be added to their business model,” said Ms Gartlan. “It will not be uncommon for providers to seek additional funding to support this potential cost increase.”
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