news
Bright idea
for funding
New funding model put
forward for aged care shifts
focus away from providers.
By Dallas Bastian
T
he government has praised a
new funding model proposed for
residential aged care.
Called the Australian National Aged Care
Classification (AN-ACC), its authors say it
explicitly focuses on improving quality of
care, rather than paying providers.
Professor Kathy Eagar, director of the
Australian Health Services Research Institute
at the University of Wollongong (UOW),
said the model zeroes in on improvements
in care and rids the “perverse quality
incentives of the current model”.
Under AN-ACC, homes would not be
able to select residents based on their
payment class.
“If the AN-ACC class assessment is
undertaken prior to entry, the facility is not
advised of the resident’s payment class
until after the person is in care,” but would
still get Aged Care Assessment Team
(ACAT) and referral information, the UOW
team wrote.
The government has been examining
options for a new funding tool and
system to replace the Aged Care Funding
Instrument (ACFI) since 2017.
Aged Care Minister Ken Wyatt called
the proposed funding model “new and
improved”, saying he was “very excited” by
the results of the study.
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agedcareinsite.com.au
He said: “The university’s
comprehensive research could be a
game changer for aged care because the
proposed new system is a completely
different way of allocating funding for
residential aged care.
“The proposal includes the removal of
identified flaws in the ACFI, including the
complex and time-consuming assessment
process as well as eliminating incentives
not always found to be in the best
interests of consumers.”
The UOW team, which was
commissioned by the government, said
consumers, providers and the government
will, for the first time, be able to make
meaningful judgements about the quality
and outcomes of residential aged care and
fairly compare the quality of care provided
at different facilities.
“This is the ultimate measure by which
the aged care sector should be judged,”
they wrote.
The government recently held a
stakeholder reference group to look
over the model and it heard strong
endorsement of its ideas.
Eagar said the key message from the
sector at that meeting was that they want
to move on a replacement now.
The funding model is based on six key
design elements:
1 Resident assessment for funding to be
separate from resident assessment for
care planning purposes
2 Assessment for funding purposes to
be undertaken by external assessors
capturing the information necessary to
assign a resident to a payment class
3 Assessment related to care planning to
be undertaken by the residential aged
care facility based on resident needs
and underpinned by consumer directed
care principles
4 Provision of a one-off adjustment
payment for each new resident that
recognises additional, but time-limited,
resource requirements when someone
initially enters residential care
5 A fixed price per day for the costs
of care that are shared equally by all
residents. This may vary by location and
other factors
6 A variable price per day for the costs
of individualised care for each resident
based on their AN-ACC casemix class.
AN-ACC is made up of a fixed payment
for shared costs, a variable payment for
individual resident costs and an adjustment
payment for entry costs.
An attached discussion paper from the
Department of Health said: “Under the
AN-ACC, the subsidy paid to the provider
would consist of a fixed component and
a variable component for each resident.
Providers would also be paid an adjustment
payment on a time-limited basis when a
new resident enters the facility.
“The staff time data collected in the
[Resource Utilisation and Classification
Study] indicated that close to 50 per cent of
staff time was spent delivering care tailored
to the specific needs of the resident, while
the remaining 50 per cent was spent
delivering shared care across all residents.
This supports a payment model that
includes a fixed per diem price for the costs
of shared care and a variable price per day
for the costs of individual resident care.”
Eagar said the UOW team’s key message
to the government was that the model
should be adopted as a package of reform
and not seen as a smorgasbord from
which to pick and choose.
Wyatt said both the aged care sector
and the government still have a lot of hard
work to do before the AN-ACC can be
implemented.
However, he added: “There is no
doubt in my mind that implementing the
AN-ACC would better identify the needs
of individuals in residential aged care
and better allocate resources to meet
their needs.”
The government said it is now seeking
sector and community feedback to help
inform decisions on funding reform and
the design elements of the proposed new
funding model. Consultation is open until
31 May 2019. ■