23 Jun Care Management under Support at Home is chaos
When the Australian Government introduced the new Support at Home program, most providers focused on funding categories, participant contributions and the transition away from Home Care Packages.
But one of the biggest changes was happening quietly in the background –
Care Management under Support at Home was completely re-engineered.
For providers, this isn’t simply a new billing code. It’s an entirely different way of funding, recording and claiming the work that Care Managers—now known as Care Partners—do every day.
And for many organisations, it has become one of the most administratively challenging parts of Support at Home.
In comes the Care Partner
Under Support at Home, Care Managers become Care Partners.
The title change reflects a broader expectation that these workers will work closely with older people to coordinate services, review goals and support changing needs.
The challenge? The funding model has changed dramatically.
Under the Home Care Packages Program, providers could claim up to 20% of a client’s package value for care management, regardless of how much support that individual required. And, on top of that they could charge up to 15% for Package Management- processing invoices and claims against the package.
Care Management under Support at Home:
- Only 10% of ongoing funding is set aside for care management.
- Funds are pooled across all clients at the service delivery branch.
- Care management must be claimed in arrears, linked to specific activities and recorded against individual clients.
- Every claim must be supported by evidence and itemised using billing codes.
This means providers can no longer rely on a fixed percentage of package income to cover their care coordination costs.
Care Management is no longer “set and forget”
Under the new model, Services Australia sets aside 10% of each client’s ongoing budget into a pooled Care Management account at the beginning of every quarter.
This creates new operational questions:
- How much care management time is each client consuming? Each client must have at least 15 minutes per month of Care Management activities recorded.
- Are some clients requiring significantly more support than others? The answer to that is “yes”, for sure.
- Are you under-utilising the pooled funds? It is essential this pool of funds is expended – an element of use it or lose it!
- What happens if new clients commence mid-quarter? Care Management funds for new clients only get added at the start of a quarter.
Providers need to monitor their Care Management pool to make sure all funds available are claimed.
Every minute needs to be counted
One of the most significant changes is that Care Management is longer a given.
Claims must now be:
- Itemised to an individual client
- Linked to a date of service
- Supported by case notes
- Claimed in 15-minute increments
- Submitted against the specific billing code SERV-0018.
This has created a substantial new administrative burden, which legacy systems are not managing.
For organisations with hundreds or even thousands of clients, manually tracking these activities through spreadsheets is quickly overwhelming.
What counts as Care Management?
Many activities that Care Partners undertake can be claimed, including:
- New client assessments
- Client phone calls
- Documentation and file reviews
- Support Plan reviews
- Family discussions
- Coordination with external providers
- Liaising with GPs and hospitals Home visits and support reviews
- Broad planning around Assistive Technology and Home Modifications.
Importantly, every client must receive:
- At least 15 minutes of care management per month
- A formal care review every 12 months or sooner if their needs change.
What doesn’t count?
This is where many providers may be caught out.
Under Support at Home, you cannot claim for many activities that historically sat within care management, including:
- Rostering and scheduling
- Training staff
- Travel time
- Submitting claims
- Governance and compliance activities
- Operational reporting
- Recruitment and performance management.
These activities still need to happen.
The difference is that providers now need to recover these admin costs elsewhere, within their pricing structures.
For many organisations, this is the key reason service prices have increased under the new program.
Self-managed clients still require Care Management under Support at Home
There is a common misconception that self-managed clients won’t require Care Partners.
The opposite is true.
Even where clients manage some or all of their services themselves, providers must still:
- Assist clients to prioritise goals and needs.
- Ensure services being purchased are eligible.
- Conduct care management activities every month.
- Maintain documentation and claims evidence.
Providers may also apply a 10% mark-up to compensate for checking the credentials of self-managed contractors.
Then there is Care Management as part of the new short term budgets under Support at Home.
If managing one pool wasn’t enough, Support at Home introduces several different care management funding streams:
1. Ongoing pooled Care Management
- 10% pooled funding spread across all clients in the Service Branch
- Claimed using SERV-0018.
2. Assistive Technology
- Up to 10% of the cost of the bundle (item + delivery) or $500 whichever is less
- Claimed using SERV-0066.
3. Home Modifications
- Up to 15% of the quoted cost or $1,500 whichever is less
- Claimed using SERV-0068.
4. Restorative Care
- No cap, but expenditure must be proportionate.
- Claimed using SERV-0019.
5. End of Life Care
- No cap, but expenditure must be reasonable.
- Claimed separately against the End of Life budget but using the same billing code as pooled Care Management SERV-0018.
Each pool has different rules, different limits and different claiming requirements.
The spreadsheet problem
Many providers are asking:
“How do we keep track of all of this?”
The reality is that spreadsheets are longer enough.
Under Support at Home, providers will need systems capable of:
- Tracking care management time across the Service Branch.
- Recording activities against individual clients.
- Monitoring multiple short-term budgets from which care management can be drawn
- Producing evidence for claims.
- Managing quarterly Ongoing Support at Home balances and carryovers.
- Ensuring compliance with Services Australia requirements.
Without the right systems in place, organisations risk:
- Lost revenue
- Missed claims
- Increased administration costs
- Staff burnout
- Compliance exposure
The opportunity hidden in the complexity
While the new rules undoubtedly create complexity, they also provide an opportunity.
Providers that invest in the right systems and processes now will be able to:
- Understand the true cost of care management.
- Improve operational efficiency.
- Reduce manual administration.
- Strengthen compliance.
- Give Care Partners more time to focus on what matters most—supporting older Australians.
Because under Support at Home, success won’t simply depend on delivering care.
It will depend on being able to prove, record and manage every piece of care coordination that sits behind it.
And that’s a very different world from the one providers have known under Home Care Packages.
Still managing the five different Care Management funding pools with spreadsheets?
There is a better way.
VIPS Care automates the complexity, tracks claims in real time and helps your team spend less time on administration and more time supporting clients.
Because Care Management under Support at Home shouldn’t require an army of spreadsheets to make it work.