Support at Home Is Quietly Changing How Home Care Providers Make Money

For years, the economics of home care were relatively predictable.

Acquire a client. Manage the package. Deliver services.

And importantly, maintain a layer of ongoing revenue through package and care management fees.

Support at Home changes that.

Not loudly. Not all at once. But structurally.

The Old Model Rewarded Holding a Package

Under the Home Care Package system, providers often received:

• Package management fees

• Care management fees

• Ongoing revenue not directly tied to service volume

In many cases, combined management fees sat somewhere between 20% and 30%+ of the total package value.

That created a stable operating model.

Growth was largely driven by:

Acquiring more packages.

Not necessarily by:

Increasing ongoing client engagement.

ITCF Also Changed Consumer Behaviour. The old Income Tested Care Fee (ITCF) created another dynamic.

Many self-funded retirees and part pensioners were paying:

• $20–$30+ per day

• Regardless of how many services they actually used

That often led families to think:

“We may as well use more services if we’re paying anyway.”

Some increased usage to justify the cost.

Others avoided the system altogether and funded services privately.

Neither behaviour was irrational. They were responses to the structure of the system.

Support at Home Changes the Equation

The introduction of:

$0 clinical contributions

is a major behavioural shift. Consumers can now access:

• Nursing

• Physiotherapy

• Podiatry

  • and more from the clinical bucket

without out-of-pocket contribution, regardless of their financial position.

That changes the psychology completely.

Consumers No Longer Need to “Get Value” from a Daily Fee

Under Support at Home, clients are more likely to think:

“We’ll use the services that actually help.”

Not:

“We need to maximise the package because we’re paying for it.”

That sounds subtle.

It isn’t.

Revenue Is Shifting from Allocation to Participation

This is the real structural change.

Historically, a portion of provider revenue was connected to:

• Holding the client

• Managing the package

Increasingly, revenue will depend on:

• Actual service delivery

• Ongoing utilisation

• Consistent client engagement

In other words:

Providers are moving from passive revenue models to earned revenue models.

Most Providers Are Not Structured for This Yet

Traditional tech and subscription businesses often separate functions into:

• New business

• Account management

• Customer success

Most home care providers do not.

Even advanced providers may only have:

• Intake teams

• Care managers

• Rostering and operations

And care managers are not designed to think in terms of:

• Service expansion

• Engagement depth

• Share of wallet

• Utilisation optimisation

Nor should they be forced into purely commercial roles. But the operating model around them is changing regardless.

The Providers Who Adapt Will Look Different

The providers likely to perform well under Support at Home will be those who can:

• Maintain high clinical relevance

• Keep clients actively engaged

• Deliver services efficiently

• Demonstrate ongoing value over time

Not simply:

Hold packages.

The Next Shift May Be Even Bigger

One potential future reform already being discussed is:

Allowing consumers to use multiple providers simultaneously.

For example:

• One provider for domestic assistance and gardening

• Another for nursing and clinical services

Technically, the broader government infrastructure already has the capability to support this kind of split-service environment.

If introduced, it would fundamentally change provider competition.

Clients would no longer choose:

One provider for everything.

They would choose:

The best provider for each need.

What That Would Mean

A multi-provider model would likely accelerate:

• Specialisation

• Competition on quality

• Consumer choice

• Pressure on passive revenue structures

And it would raise a difficult strategic question for providers:

“Why would a client continue using us specifically?”

That is a very different market dynamic to the one the sector has historically operated within.

Bottom Line

Support at Home does not just change funding.

It changes behaviour.

For consumers:

• Less forced spend

• More selective service use

• Greater focus on practical value

For providers:

• Less reliance on management fees

• Greater dependence on engagement and utilisation

• A growing need to earn relevance continuously

This is not about good providers or bad providers. It is about a structural shift in how the system works, and many organisations have not fully adjusted to what that means yet.

Final Thoughts

For consumers, Support at Home represents a more flexible and practical system, particularly for those who previously avoided care due to Income Tested Care Fees and ongoing contribution concerns.

For providers, the implications are broader.

The sector is gradually moving away from a model where revenue was partially protected by package structures and management fees, toward one where engagement, utilisation and ongoing relevance matter more than ever.

That shift will reward providers who:

• Deliver clear value

• Stay clinically relevant

• Build stronger ongoing relationships with clients

And while the transition will take time, the direction of travel is becoming increasingly clear:

Consumers are gaining more choice, more flexibility and more control over how they use support.

The providers best positioned for the future will be the ones prepared to adapt to that reality early.

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