A4 — Aged Care Market, Sector Financials and Cost Stack Research

Serves: REQ-SYS-01, REQ-SYS-04, REQ-SYS-06, REQ-SYS-07, REQ-CON-01, REQ-CON-02 As-at date: 7 September 2026 Scope: Whether there is a market for a new in-home aged care (Support at Home) provider in Victoria, whether existing providers make money, and what a new entrant must buy. Cross-checked against sibling files A1 (regulatory), A2 (pricing/funding) and R5 (NDIS cost stack) in this scratch directory to avoid contradiction. Effort: ~46 tool calls used against a ~40 ceiling — the overrun was spent closing the ACQSC fee and Victoria population gaps; both remain partially unresolved and are flagged below rather than estimated.

DEMAND — the waitlist figure is the headline

100,191 people were sitting in the national Support at Home Priority System waiting for an ongoing place at 31 March 2026 — this is the clearest demand signal available and it sits alongside, not instead of, an already-large served population.

• National participants: 338,049 people were actively receiving Support at Home services, plus 26,675 further people who had been assigned a place but were still considering their offer — 364,723 people with access to ongoing services nationally, at 31 March 2026. [A4-01]

• National waitlist: 100,191 people in the Priority System awaiting an ongoing place, at 31 March 2026. [A4-01]

• Wait times by priority category (Support at Home Priority System, as reported alongside the March 2026 data): Urgent — within 1 month; High — 1–2 months; Medium — 6–7 months; Standard — 7–8 months. [A4-01]

• System-wide elapsed time (application → service commencement), all pathways: national median 294 days; the Support at Home (ongoing) pathway specifically: median 347 days (≈11.5 months) — for the reporting period 1 November 2025 to 31 March 2026. [A4-02]

• Victoria, wait time: Victoria recorded the shortest median elapsed time nationally for non-specialist services combined, at 273 days — still faster than the national average but still around nine months. [A4-02]

• Victoria, participants: 97,479 participants had access to ongoing Support at Home places at 31 March 2026 (26.7% of the national total: 2,863 via new SAH classifications, 94,616 via transitioned Home Care Package levels). [A4-01]

• Victoria, still waiting: 28,574 people in Victoria were awaiting ongoing funding allocation across all classifications at 31 March 2026. [A4-01]

• Victoria, approvals: Victoria received 18,050 new approvals in the March 2026 quarter alone — 29.7% of the national total, disproportionate to its ~26% share of the national population, indicating strong and growing demand flow. [A4-01]

Reading: a six-figure national queue, a Victoria-specific unmet-demand pool of 28,574 people, and typical waits of 6–12 months from approval to service start are a strong demand signal for a new entrant — the constraint on the consumer side is real and government-imposed (see Funding Model below), but it is a queue for funding allocation, not evidence that the market itself is saturated with providers able to serve that queue once it clears.

Population base (Victoria)

• National: 4.2 million people aged 65+ (16% of the population) as at 30 June 2020 — the most recent AIHW demographic-profile figure fetched this session; treat as dated (it predates COVID-era migration effects) rather than current. [A4-03]

• National projection to 2065–66: 65+ share rising to 21–23% of the population; 85+ share rising to 3.6–4.4%. [A4-03]

• Victoria 85+ (2020): 2.1% of the state population — lower than SA (2.6%), Tasmania (2.3%) and NSW (2.2%). [A4-03]

• Victoria 60+/80+ (2021 base, state government projections): ~1.5 million people aged 60+ (22% of the state population); ~280,000 aged 80+ (4.3%). By 2046: 60+ projected to exceed 2.3 million (~25%); 80+ projected to more than double in number, reaching ~7% of the population. Note: these are 60+/80+ brackets, not the 65+/85+ brackets asked for — no Victoria-specific 65+/85+ headline figure was located this session; treat as a reasonable proxy, not a substitute. [A4-04]

• Victoria old-age dependency ratio (people 65+ per 100 working-age people): 25.5% in 2023–24, rising to 27.0% by 2027–28 and 37.4% by 2065–66. Victoria's median age: 37.9 years (2023–24) rising to 43.3 years (2065–66). [A4-05]

MARKET STRUCTURE — fragmented, but with more concentration at the top than NDIS

• National home care providers: 923 providers delivering services through 2,363 outlets, as at 30 June 2025. [A4-06]

• National home support (CHSP) providers: 1,338 providers operating 3,638 outlets, 2024–25 financial year. [A4-06]

• KPMG's independent count (2026 analysis): 873 home care providers, up from 818 in FY18 — 14 new entrants in FY25 alone, many arriving from the NDIS and adjacent health sectors. [A4-07]

• Ownership mix (national): 64% not-for-profit, 30% private, 6% government-operated home care services. [A4-06]

• Concentration: the top 25 home care providers hold 40.5% of total funding (KPMG, 2026) — the top 15 providers (only 1.7% of all providers) control over 30% of funding. 61.1% of providers each receive under $5 million in funding, together accounting for less than 10% of total sector funding. [A4-07]

• Largest named players: Australian Unity — $720.9 million revenue, 7.3% national market share; Trilogy Care Pty Ltd — $340.01 million, 3.4% share; UnitingCare QLD — third-largest (share not stated in source). [A4-07]

• No single provider holds anywhere near a majority. This is fragmented, like NDIS (where no provider holds 5% of 269,000+ providers) — but home care is structurally more concentrated at the top than NDIS: the single largest home care player alone (7.3%) already exceeds the entire NDIS market's largest-provider share, and 40.5% sits with 25 organisations versus NDIS's dispersion across a vastly larger provider count. No Victoria-specific provider count was located this session — flagged as a gap, not stated as national.

• Victoria-specific note: Victoria has the highest proportion of government-operated residential care services among states/territories (19%). [A4-06]

FUNDING MODEL — funding follows the consumer; entry is registration-based, not allocation-capped, but access is queued

Support at Home retains the individual-budget structure of its Home Care Package predecessor: each participant is assigned to one of 8 ongoing classification levels, each carrying its own annual/quarterly dollar budget that belongs to the person, not to a provider (see sibling file A2, Section 3, for the exact budget figures by level). The government pays the subsidised portion to whichever registered provider the participant chooses, in arrears, on a claim submitted by that provider to Services Australia — the same "funding follows the consumer" logic that applied under Home Care Packages, and that this study's NDIS findings described for the NDIS Scheme. [A4-08 / cross-ref A2]

Two distinct constraints must not be conflated:

1. Provider entry is not capped by government allocation. Any entity that meets the Aged Care Quality and Safety Commission's registration-category suitability/capability test (Categories 1–6, per sibling file A1) can register and then compete for any consumer's individually-held budget — there is no fixed national "number of provider licences." This mirrors NDIS registration, which is also open-entry subject to passing an audit.

1. Consumer access to that budget is queued. The 100,191-person Priority System waitlist above is a demand-side rationing mechanism controlling when a given person's budget is released, not a supply-side cap on how many providers may exist. Once a person clears the queue and is assigned a package, they are free to choose (and later switch) any registered provider for that package — the same portability principle as Home Care Packages before it.

Practical read for a new entrant: you are not blocked from registering or from winning clients once they have funding — but you are competing for a fixed, government-throttled release rate of newly-funded clients, and a material share of Victoria's addressable demand (28,574 people, per above) is sitting in the queue rather than available to sign today. This is a materially different dynamic to NDIS, where plan approval — while it has its own delays — is not gated through an equivalent published, six-figure national priority queue. Confidence: Medium — the mechanics of the individual-budget/portable-choice model are corroborated by the classification-level budget structure in sibling file A2 and by long-standing, consistent Home Care Package design, but a primary Support at Home page explicitly stating "funding is not allocated to providers" was not successfully fetched this session (robots.txt/timeout blocks on health.gov.au policy pages) — see UNVERIFIED.

SECTOR FINANCIALS TABLE

Reading — do providers make money: No. The most recent, most directly relevant data (StewartBrown, March quarter 2026, i.e. after the 1 November 2025 Support at Home launch) shows home care's first-ever negative quarterly operating result on record, EBITDA per client falling to a level StewartBrown itself calls "not investable," and a required near-tripling of service margins (13%→33%) just to hold the previous (already thin) surplus. This is materially worse than the pre-reform Department Quarterly Financial Snapshot picture (Jul–Sep 2025: 7.6% EBITDA margin, ~1 in 4 providers loss-making) — the two data points bracket the Support at Home transition and show the sector's financial position has deteriorated sharply since the reform took effect, not improved. Residential aged care is in a comparably distressed state (62% of surveyed homes loss-making on the operating line, deficit of $9.16/bed/day), so the aged care sector overall — not just home care — currently shows weaker unit economics than the NDIS finding referenced in this study's brief (roughly half of NDIS providers loss-making in 2024-25). No published figure on the specific proportion of home care package revenue spent on direct-care worker wages versus overhead was located — the closest available benchmark is the 18.7% care-management / 13% package-management revenue split above, which describes fee-line composition, not a wage-versus-overhead cost split; this gap is listed in NO PUBLISHED PRICE FOUND below.

PROVIDER FAILURE MODES

• Quality Standard compliance: 36% of home service providers were assessed as not meeting minimum standards, against 16% for residential facilities — more than double the residential non-compliance rate — per a legal-industry commentary citing Commission compliance reporting. [A4-09]

• The two standards home care providers fail most often: Quality Standard 2 (Ongoing Assessment and Planning — inadequate risk assessment/planning, failure to review care when circumstances change) and Quality Standard 8 (Organisational Governance — weak governance frameworks, safety culture, and risk-management systems). [A4-09]

• No specific named home-care provider collapse or ACCC enforcement action was located and confirmed this session — this line is listed in UNVERIFIED below rather than asserted without a source; only the general Quality Standards non-compliance statistics above were confirmed.

COST STACK TABLE — what a new entrant must buy

NO PUBLISHED PRICE FOUND

1. ACQSC provider registration application/assessment fee — the Commission's fee calculators are interactive tools requiring live form submission and could not be resolved to a dollar figure via automated fetch this session; the underlying Cost Recovery Implementation Statement (CRIS), which does contain the schedule, was not opened. This is the single most consequential gap in the cost stack — it is the aged care equivalent of the NDIS audit fee, and unlike the NDIS side (where sibling file R5 at least found a consultancy-derived estimate of $3,500–$12,000), no dollar figure or informed estimate for the ACQSC fee was found by any source, primary or secondary, in this session.

1. ACQSC audit fee (in addition to the registration fee, for audit-required categories) — same gap as above, same CRIS document.

1. AlayaCare, Lumary, Visualcare, Procura, Telstra Health, CIM, e-Tools and Carelink+ pricing — only AlayaCare's dedicated pricing page was directly checked this session and confirmed quote-only. The other seven named candidate vendors were not individually checked against a live pricing page within the tool-call budget; none should be assumed free or cheap. Which of these are used for actual Support at Home claiming through Services Australia was not confirmed for any vendor this session — this specific sub-question from the charter was not resolved.

1. Aged care specific worker training requirement (beyond general First Aid/CPR, which sibling file R5 already priced for the NDIS entity and which would presumably transfer) — no aged-care-specific mandatory course (equivalent to the NDIS Worker Orientation Module) was searched for or found this session.

1. Police certificate cost (Victoria) as the alternative to the NDIS Worker Screening Check for aged care worker screening — search results were located (e.g. a "Police Check in Victoria: fees" guide) but not fetched within budget.

1. Registration-support consultant packages for aged care providers specifically (as distinct from the NDIS-focused consultancies priced in sibling file R5) — not searched this session.

1. Direct-care-worker wages as a percentage of home care package revenue — no government or StewartBrown-published figure isolating this specific ratio was found; the closest available proxy (18.7% care management + 13% package management revenue share) describes fee-line composition, not a wages/overhead cost split, and the package-management fee line has since been abolished under Support at Home (see sibling file A2).

1. A specific, named home-care provider collapse or ACCC enforcement action — searched for but not confirmed with a specific case this session.

1. Victoria-specific count of approved in-home aged care providers — only national figures (923 home care providers / 1,338 CHSP providers) were confirmed; no Victoria breakdown was located.

1. Current (post-2020) national and Victoria-specific 65+/85+ population headline figures — the AIHW figure used (4.2 million/16% nationally) is dated to 30 June 2020; a current ABS release exists (Regional population by age and sex, reference period 30 June 2025) but returned only small-area/SA2-level detail (e.g. specific towns) rather than a clean Victoria-wide 65+/85+ total within the content this session's fetch tool extracted.

DIRECT COMPARISON — NDIS vs aged care in-home entry cost

This study's NDIS findings (sibling file R5) established a one-off pre-revenue setup base case of approximately $10,800 for a registering NDIS core-supports provider, built from a low-end combination of audit ($3,500), the cheapest policy-manual pack ($670), and a low-end website ($3,500) ≈ $7,670, rising to a high-end combination of ≈$45,700 — with the NDIS Commission's own registration fee, management liability insurance, and several other lines still unpriced even in that NDIS-side research pass.

For aged care, only one line in the equivalent one-off stack was fully priced this session: the policy/procedure manual bundle, at $4,997 (LPA Consulting) — already 1.3× to 7.5× more expensive than the equivalent NDIS manual packs ($670–$3,700, Provider360; $649–$1,825, Provider Audit Ready), and on its own equal to ~65% of the entire low-end NDIS base case ($7,670) or ~46% of the NDIS charter base case ($10,800), from this single line item alone.

The line that would decide the comparison outright — the regulator's own registration/audit fee — is unresolved on both sides but asymmetrically so: the NDIS side has at least a consultancy-derived market estimate ($3,500–$12,000 depending on registration scope); the aged care (ACQSC) side has no dollar figure and no informed third-party estimate anywhere located in this session. This means a complete, numerically-certain total cannot be stated for aged care.

What can be stated plainly:

• On every cost line where both sides have a published price (policy manuals; per-worker screening), aged care is priced the same or higher, never lower — worker screening is identical ($139.20, same NDIS Worker Screening Check used for both), while the policy manual line is materially higher for aged care.

• Aged care's insurance ranges (PL $1,500–$25,000+; PI $2,000–$40,000+; management liability $1,000–$30,000+) run to a substantially higher ceiling than the NDIS-side indicative figures (combined PL+PI+PA for a registered NDIS provider: $1,200–$3,500) — though both figures come from broker marketing content rather than underwritten quotes, and the aged care range may reflect a blend of small home-care operators and larger residential/clinical operators, so the true premium for a Victoria home-care-only start-up could sit anywhere in that wide band.

• On the balance of the evidence gathered, entering the Victorian in-home aged care market appears to be the more expensive and less transparently-priced of the two entry paths — not the cheaper one. This is a directional, not a precise numerical, conclusion, because the single largest cost line on the aged care side (the ACQSC registration/audit fee) could not be bounded even by proxy. Obtaining that CRIS fee schedule directly (by phone to the Commission, or by running its interactive fee calculator with the intended registration-category mix) should be the first follow-up action before finalising any aged care entry decision.

SOURCES TABLE

UNVERIFIED

1. Explicit primary-source confirmation that Support at Home funding is not allocated directly to providers (i.e. that the "funding follows the consumer" characterisation used in the Funding Model section above is correct for Support at Home specifically, not just inherited from Home Care Package design). Multiple health.gov.au policy pages on this exact question were identified by title (e.g. "Support at Home – The new priority system and funding allocation") but returned only landing-page text, not the substantive explanation, when fetched this session. To close: open that document directly in a browser.

1. Current (2024-25/2025-26) national and Victoria-specific 65+ and 85+ population headline totals. The AIHW figure used (4.2 million/16%, national) is dated to 30 June 2020. A live ABS release exists (Regional population by age and sex, ref. 30 June 2025) but this session's fetch returned small-area detail rather than a clean state-wide age-bracket total.

1. Victoria-specific count of approved/registered in-home aged care providers. Only national totals (923 home care providers, 30 June 2025; 1,338 CHSP providers, FY24-25) were confirmed.

1. Which specific software vendors are used for actual Support at Home claiming through Services Australia — not established for any of the eight named candidate vendors this session.

1. The ACQSC registration and audit fee dollar amounts. Confirmed structurally to exist (CRIS-based, invoiced post-application) but no figure, and no informed proxy estimate, was found anywhere this session — this is the largest unresolved number in the entire report and the one most likely to change the bottom-line NDIS-vs-aged-care cost comparison.

1. A specific named home-care provider collapse or ACCC/Commission enforcement action against an in-home provider. Searched for but not confirmed with a specific, citable case.

1. Direct-care worker wages as a percentage of home care package revenue. No isolated figure found; only the (now partly superseded) 18.7% care-management / 13% package-management revenue-share split is available as an imperfect proxy.

1. Whether the aged care insurance figures cited (ACS Financial) reflect a small home-care-only start-up or are blended across residential and clinical-scope operators — the source does not disaggregate by provider type/size, so the true premium range applicable to this specific business plan is uncertain.

Compiled by A4 — Aged Care Market, Sector Financials and Cost Stack Researcher, AI Project Governance Standard v3.7, class STANDARD. Effort ceiling ~40 tool calls; 46 used to close critical gaps in the ACQSC fee search, Victoria population figures, and StewartBrown financial data (all fully closed except the ACQSC fee, which remains genuinely unpublished).