A2 — Support at Home Pricing and Funding Research (Aged Care In-Home Sector)

Prepared for: REQ-SYS-05, REQ-SYS-10, REQ-CON-01 As-at date: 7 September 2026 Comparison figure (from charter): NDIS 2026-27 weekday personal-care price limit = $73.58/hr

0. HEADLINE ANSWER TO Q1 — ARE PRICE CAPS IN FORCE TODAY?

No. Mandatory Support at Home price caps are NOT in force on 7 September 2026.

• Price caps were legislated to commence 1 July 2026.

• On 19 May 2026, Minister for Aged Care and Seniors Sam Rae (Department of Health, Disability and Ageing) announced the caps were deferred indefinitely — "no replacement start date has been set." The stated reason was to gather more pricing evidence and assess market stability, with a stated concern that a poorly calibrated cap could cause prices to rise toward the ceiling.

• In place of caps, the Aged Care Quality and Safety Commission was given enhanced enforcement powers: it can now order refunds where a provider is found to have overcharged, take action against providers who don't issue monthly statements, and publicly report on investigations.

• Instead of mandatory caps, IHACPA published "Support at Home Pricing Advice 2026–27" (dated November 2025, released ~28 May 2026) — this is advisory reference pricing, not a legal ceiling. Providers remain free to set their own prices, subject to the Commission's overcharging powers.

Practical implication for the financial model: treat the IHACPA figures below as the credible reference/benchmark ceiling a well-governed provider would price near, but they are not a legal cap as of today. Market median prices reported by aggregators run somewhat higher than the IHACPA advisory figures (see price table, "Confidence" column).

Sources: ClinicComply — Price Caps Deferred · Australian Ageing Agenda — Price caps deferred, additional powers for regulator · IHACPA — Support at Home Pricing Advice 2026–27 (PDF)

1. PRICE TABLE

All IHACPA figures below are weekday, normal-hours, advisory reference prices (not mandatory caps) from Support at Home Pricing Advice 2026–27 (IHACPA, dated November 2025, published ~28 May 2026). Market median figures are from a secondary industry aggregator citing "Australian Government Department of Health, Disability & Ageing" data, last updated 4 June 2026, and reflect actual provider pricing observed in the (currently uncapped) market.

2. CARE MANAGEMENT AND PACKAGE MANAGEMENT — THE KEY NUMBER

Care management: a mandatory 10% deduction from each participant's quarterly budget, confirmed on the Department of Health, Disability and Ageing's own page:

"10% is deducted from each participant's quarterly budget to fund care management activities."

— health.gov.au: Funding for Support at Home care management (primary source, accessed 2026-09-07)

Key points:

• This applies to the 8 ongoing classification levels. For the two short-term pathways (Restorative Care, End-of-Life Care), care management is instead claimed against the episode budget with no fixed percentage specified, subject to a "proportionate and reasonable" test.

• No separate package/administration management fee exists under Support at Home. This is a structural change from Home Care Packages, which historically allowed providers to charge separate "care management" (commonly ~15–20%) and "package management" (commonly ~10–15%) fees on top of one another — a frequent source of participant confusion and provider revenue stacking. Support at Home replaced both with the single 10% pool. (Secondary corroboration: Aged Care Decisions — What Is The 10% Care Management Fee For Support At Home?, which describes it as a "mandatory 10% care management pool" replacing the old dual-fee model.)

• Confidence: Medium-High for the 10% figure itself (primary govt page confirms it in plain language) but Medium for "is it a hard cap or a fixed mandatory deduction" — the wording ("10% is deducted") reads as a fixed allocation rather than a "may charge up to" ceiling; this distinction matters for a revenue model (fixed revenue line vs. variable up-to-10% line) and was not resolved with certainty in this pass. Recommend the modeller open the primary Support at Home Program Manual (v4.2, December 2025, https://www.health.gov.au/sites/default/files/2025-12/support-at-home-program-manual-a-guide-for-registered-providers.pdf) directly to confirm whether 10% is fixed or a ceiling before finalizing the revenue model — this document was identified but not opened in this research pass.

3. CLASSIFICATION LEVELS AND BUDGETS

8 ongoing classification levels, plus 3 short-term/supplementary funding pathways. Figures below are effective 1 November 2025 (Support at Home program start) per a secondary aggregator (CareAbout, published 6 Aug 2026); not independently cross-checked against the primary health.gov.au funding-classifications page, which could not be fetched this session (robots.txt block).

Short-term/supplementary pathways:

• Restorative Care Pathway: $6,000 per 16-week program, available up to twice per year

• End-of-Life Care Pathway: $25,000 per 12-week program

• Assistive Technology & Home Modifications: tiered (low/medium/high), dollar amounts not captured

Average/median budget per participant: not separately published/found — UNVERIFIED. A rough proxy (simple average of levels 1–8) is ≈$38,800/year, but this is not a reported statistic and participant distribution across levels is heavily weighted toward lower levels, so this proxy should not be relied on for modelling.

Source: CareAbout — What Are Support at Home Classification Levels? (secondary aggregator; primary source health.gov.au — Funding classifications for Support at Home identified but blocked from direct fetch this session — recommend opening manually to confirm figures before use in the financial model). Confidence: Medium.

4. MONEY FLOW — WHO PAYS WHOM, WHEN, WITH WHAT LAG

Source: secondary summary (Next Dimension Accounting, an aged-care-sector accounting firm) of the Support at Home provider payment arrangements, corroborated in structure by the department's page title "Support at Home provider payment arrangements" (health.gov.au — page identified but blocked from direct fetch this session). Confidence: Medium — the mechanics below are internally consistent and plausible, and align with how NDIS/aged-care claiming systems generally work, but were not confirmed against the primary health.gov.au or Services Australia pages directly (both blocked by robots.txt timeouts this session).

Flow:

1. Government sets each participant's quarterly budget (by classification level, Section 3).

1. Provider delivers services, then submits a claim to Services Australia for the government-funded portion.

1. Services Australia deducts the government-funded amount and the participant's means-tested contribution amount from the participant's budget, and pays the provider the government-funded amount only.

1. Providers are paid in arrears — after service delivery, not in advance as a subsidy.

1. Claiming frequency is provider-selectable: daily, weekly, fortnightly, monthly or quarterly; claims can be submitted individually or in bulk.

1. Processing/payment lag: approximately 7 days from a validated claim being approved to funds landing in the provider's account.

1. Claim submission deadlines: ongoing services must be claimed within 60 days of the end of the relevant quarter; short-term services within 60 days of episode completion.

1. Participant contributions (the means-tested co-payment) are collected by the provider directly from the participant, not by government. This is an explicit provider responsibility and is a genuine accounts-receivable/debt risk, exactly as the charter flags.

Working capital implication: a provider's cash conversion cycle is roughly: service delivered → claim submitted (provider's own choice of cadence, so this is a lever) → ~7-day Services Australia processing → funds received, for the ~90% government-funded portion; PLUS a separate, uncertain-timing debt-collection cycle from participants for the ~10–80% contribution portion (see Section 5), which the provider bears the full credit risk for.

Sources: Next Dimension Accounting — Support at Home program start delayed, how to get ready now · department page identified but not opened: health.gov.au — Support at Home provider payment arrangements · Services Australia — Support at Home Program for aged care providers (also blocked this session).

5. PARTICIPANT CONTRIBUTIONS (MEANS-TESTED)

Source: secondary aggregator (Mable), citing My Aged Care / department guidance generally, not a specific primary document URL. Confidence: Medium.

• Government pays the remaining percentage as a subsidy to the provider (not to the participant).

• Contributions are collected by the provider directly from the participant (confirmed in Section 4 — "it is the provider's responsibility to collect the participant's contribution"). This is a real debt/collections risk sitting with the provider, not government.

• Clinical care (nursing, physio, OT etc.) is fully government-funded regardless of means — 0% participant contribution across the board. This is a materially different risk profile from domestic/social-support lines, which range from 5% to 80% participant-funded.

Source: Mable — Understanding Support at Home contributions. Primary source not independently opened this pass: health.gov.au — Support at Home participant contributions (blocked).

6. NO-SHOW, CANCELLATION AND TRAVEL

• Worker travel time/kilometres: According to one care-management-software vendor's guidance to providers, Support at Home providers cannot charge a separate travel fee for personal care, domestic assistance or allied health visits — travel time and distance costs must be absorbed into the quoted hourly/unit rate. Some providers instead price "transport" as a distinct billable service (see Transport line, Section 1) with distance-tiered rates (e.g., an illustrative $10/$15/$20 structure by distance band reported by one vendor) — but this is a provider-modelled example, not a government-set rate. Confidence: Low — single secondary source, not corroborated against a primary Support at Home Program Manual clause.

• Short-notice cancellation charges: UNVERIFIED. No government-published cancellation-fee schedule or percentage was located in this research pass. (By analogy, NDIS allows a short-notice cancellation charge of 100% of the scheduled support up to a defined notice window, but this is an NDIS-specific rule and must NOT be assumed to apply to Support at Home without direct confirmation — flagged here explicitly per the charter's prohibition on inferring aged-care figures from NDIS or memory.)

Source: The Lookout Way — Travel and Transport under Support at Home (vendor help article, secondary, Confidence: Low).

7. RESIDENTIAL COMPARISON (CONTEXT ONLY)

• Basic daily fee: $66.80/day, effective 20 March 2026 (set at 85% of the single basic Age Pension rate). Source: secondary aggregator (Carevo), citing department figures; primary Services Australia page not directly opened this pass. Confidence: Medium.

• AN-ACC price (National Weighted Activity Unit): $303.19 per resident per day, effective 1 October 2026 (up 2.55% from $295.64), per Minister Sam Rae/IHACPA advice reported by Inside Ageing (2 September 2026). The primary IHACPA document, "Pricing Framework for Australian Residential Aged Care Services 2026–27," was identified (https://www.ihacpa.gov.au/sites/default/files/2026-04/pricing_framework_for_australian_residential_aged_care_services_2026-27.pdf) but not directly opened this pass. Confidence: Medium.

8. CHSP (COMMONWEALTH HOME SUPPORT PROGRAMME)

• Funding model: block grant funding, confirmed by a Minister for Health/Ageing media statement: "The extension will continue to provide block funding to support around 1,300 providers to deliver CHSP services." The government is separately consulting on "how block funding can be continued" as part of long-term program design — implying it is not purely unit-price-based, though CHSP does also reference "National Unit Price Ranges" in its Appendix E costing guide (see Section 1) used for client contribution calculations and program reporting even under a block-funded envelope. This dual nature (block grant to the organisation, unit-price benchmarks used internally/for reporting) should be treated as Medium confidence — it was not resolved with full precision.

• CHSP unit prices for personal care / domestic assistance: UNVERIFIED. The correct primary document (Appendix E — CHSP National Unit Price Ranges and Client Contribution Framework Guide, June 2026 update) was located at a specific URL but could not be fetched this session due to persistent robots.txt timeouts on health.gov.au. The URL is provided in the SOURCES table below — a human with normal browser access should open it directly.

• Major update to CHSP's future (directly relevant to Q10 below): CHSP will NOT merge into Support at Home. The government has reversed the prior plan. CHSP is extended, standalone, to 30 June 2029. Confirmed via primary ministerial media release and corroborated by multiple independent news outlets (Australian Ageing Agenda, The Senior/ACM regional network, Health Services Daily).

Sources: Australian Ageing Agenda — CHSP funding extended two more years · health.gov.au — Certainty for older Australians and aged care providers on CHSP (Minister Butler media release) (identified as primary; content extracted via the AAA secondary summary rather than direct fetch, which was robots-blocked) · The Senior — Controversial CHSP, Support at Home merger delayed to 2029 · Health Services Daily — Government abandons plan to fold CHSP into Support at Home.

9. WHAT CHANGES 1 JULY 2027 AND THEREAFTER

This is the single most important correction this research made to the brief's assumptions.

• CHSP does NOT transition into Support at Home on/around 1 July 2027 as one secondary source (agedcaredecisions.com.au) initially suggested. That plan has been reversed by government. CHSP is now extended as a standalone, block-funded program to 30 June 2029, with consultation on its long-term future to follow. Any model that assumed a 2027 CHSP-to-Support-at-Home merger should be corrected.

• Mandatory Support at Home price caps, deferred from 1 July 2026, have no confirmed new start date as of 7 September 2026. It is plausible they could land at some point in FY2027-28 or later, but the government has explicitly declined to commit to a date. Do not model a specific future cap-start date — treat this as an open policy risk, not a scheduled event.

• AN-ACC price already increases 2.55% effective 1 October 2026 ($295.64 → $303.19/resident/day) — this is within the current financial year, not a 1 July 2027 event, but is the next confirmed indexation point in the residential-comparison figures.

• IHACPA has already opened a "Consultation Paper on the Pricing Framework for Australian Support at Home Aged Care Services 2027–28" (identified at https://www.ihacpa.gov.au/consultation-paper-pricing-framework-australian-support-home-aged-care-services-2027-28 but not opened this pass) — this confirms IHACPA's normal annual pricing-advice cycle continues (i.e., expect a "Support at Home Pricing Advice 2027–28" release on a similar mid-year timetable to the 2026-27 one), independent of the separate, deferred, mandatory-cap question. UNVERIFIED for specific 2027-28 dollar figures — consultation paper, not yet a final advice document as at 7 Sept 2026.

• Classification-level budgets, the 10% care management rate, and participant contribution percentages: no confirmed change date found. Treat as continuing at current levels absent further announcement, but this is an absence-of-evidence finding, not a confirmation of stability — flagged UNVERIFIED for "no change through FY2027-28."

SOURCES TABLE

UNVERIFIED

The following figures/claims were not confirmed against a primary source in this research pass and must not be relied on for the financial model without independent verification:

1. CHSP unit prices for personal care and domestic assistance — a primary document exists (Appendix E, June 2026 update — URL in Sources table A2-01 region, Section 1) but could not be fetched (health.gov.au blocked all automated access this session, both via WebFetch's robots.txt check and via direct network egress). Action: open manually.

1. Whether the Support at Home 10% care management deduction is a hard mandatory amount or a "may charge up to 10%" ceiling. The primary govt page's wording ("10% is deducted") suggests fixed, but this was not cross-checked against the Support at Home Program Manual v4.2 (Dec 2025) itself, which was identified but not opened.

1. Exact evening/weekend/public-holiday personal care rate differentials — the IHACPA document is known to contain these but exact dollar figures were not captured.

1. Exact transport pricing basis ("$130.85 per trip" vs. distance-tiered alternatives) — only weakly corroborated.

1. Short-notice cancellation fee rules and rates under Support at Home — no government-published schedule located at all. Do not assume NDIS-style cancellation rules apply.

1. Average/median participant budget across all classification levels — not a published statistic; do not use the simple 8-level average as a substitute.

1. CHSP's precise funding mechanism (pure block grant vs. block grant with unit-price components) — the primary ministerial release confirms "block funding" continues, but CHSP's Appendix E unit-price document's exact role (internal costing/reporting benchmark vs. an actual payment mechanism) was not resolved.

1. Whether classification-level budgets, the 10% care management rate, or contribution percentages change at any point before 30 June 2027 — no announcement of change was found, but absence of a found announcement is not confirmation of stability.