What is the difference between self-managed and provider-managed home care?

What is the difference between self-managed and provider-managed home care?

The main difference is who handles the day-to-day organisation of your Support at Home services.

With provider-managed care, the provider arranges most aspects of your services.

With self-managed care, you or a family member take responsibility for some of those tasks.

You must still have one registered Support at Home provider under either arrangement. The provider remains responsible for care management, safety, quality and government claiming. 

Provider-managed care

Under provider-managed care, the provider generally:

• selects and arranges workers

• schedules visits

• organises replacement workers

• coordinates subcontracted services

• checks and pays invoices

• monitors the budget

• manages service problems

• communicates instructions to workers.

This may suit someone who:

• does not want administrative responsibility

• has complex health or clinical needs

• needs reliable replacement-worker arrangements

• does not have family available to help

• prefers one organisation to coordinate everything.

The participant should still be involved in choosing services, setting goals and expressing worker preferences.

Self-managed care

Under self-management, you may choose to:

• find your own workers

• select third-party service providers

• arrange schedules directly

• approve invoices

• monitor your budget

• coordinate some services yourself

• source assistive technology or home modifications.

How much you self-manage depends on your needs, abilities and preferences. The arrangement must be documented in your care plan. 

You can self-manage only selected services rather than the entire arrangement.

Who chooses the workers?

With provider-managed care, the provider normally supplies workers from its own workforce or subcontractor network.

With self-managed care, you may identify and choose an independent worker or third-party organisation.

The registered provider must still approve and formally engage that worker before Support at Home funding can be used.

Who arranges replacements?

Under provider-managed care, the provider normally arranges a replacement when a worker is unavailable.

Under self-management, responsibility depends on the agreement. You may need to find another worker yourself or ask the provider to supply a replacement.

This is an important issue where missed care could affect:

• showering and dressing

• medication

• meals

• continence care

• transfers

• other essential support.

Is self-management cheaper?

It can be.

A participant may find an independent worker charging less than the provider’s normal service price.

However, where you directly source a third-party worker, the registered provider may include an overhead of up to 10% of the third-party service cost.

Provider-managed care may cost more but can include greater responsibility for:

• sourcing workers

• scheduling

• replacement arrangements

• supervision

• invoice processing.

Does self-management remove care management?

No.

Your provider must provide care management regardless of how much you self-manage. Your care partner must continue overseeing your care plan, needs, risks and budget. (myagedcare.gov.au)

The standard 10% care-management allocation still applies to ongoing participants.

Can I combine the two approaches?

Yes.

For example, you might:

• self-manage cleaning with a local cleaner

• ask the provider to manage personal care and nursing

• arrange your own physiotherapist

• have the provider coordinate respite and replacement workers.

This can provide more choice without requiring you to manage every service.

Which option is better?

Self-management may suit you if you:

• want greater control over workers and schedules

• already know suitable workers

• are comfortable checking invoices and budgets

• have family support

• want to seek lower-cost services.

Provider-managed care may suit you if you:

• want less administration

• need complex or coordinated care

• require dependable backup workers

• do not want responsibility for worker sourcing

• prefer the provider to handle service problems.

Practical difference

1. Provider-managed care: the provider organises most/ all services for you.

2. Self-managed care: you organise selected parts/ most yourself, while the registered provider retains legal oversight and care-management responsibility.

You can change the balance later if the arrangement no longer suits your circumstances.

What should I do next?

1. Write down the services, times and practical outcomes you need.

2. Ask at least two providers for written prices and an example service schedule.

3. Check the agreement, local availability and worker backup arrangements before signing.

4. Try the Find Your Home Care Style to better understand the type of support at home that may be the better fit.

Helpful Local Home Help resources

• Compare self-managed and provider-managed care

• Find your home care style

• Browse self-managed care articles

Check the official guidance

Check the current Support at Home management guidance. Aged care rules, funding amounts and program guidance can change, so check the current official information before making an important care or financial decision.