The introduction of consumer directed care (CDC) into the home care sector in Australia has seen a fundamental shift in the delivery of in-home care and challenged organisations and consumer of care to re-look at the ‘business’ of home care.
Initially for organisations the focus was on preparing and putting systems in place to manage the billing and contracting aspects of CDC. This work was often completed internally using existing systems and processes to make judgements about charging and service offering and often without reference to consumer interests or judgements.
Rubber hits the road in consumer directed care
The system has officially been in place now since 1 July 2015 and we are beginning to see the impact of CDC in a seismic shift of consumer advocacy and engagement.
Initially we heard smattering of comments about consumers wanting ‘price lists’ and clear understanding of costs vs services.
Complaints in-home care
Now we are hearing, via news reports, of increasing complaints on the pricing of in-home care services. Here are two recent stories which illustrate my point.
- Complaints packages being fleeced by in-home care providers
- Canberra pensioner wins reprieve over in-home care service via consumer directed care
This is a level of public debate about in-home care that we have not witnessed in Australian to date.
What is the driver for this shift in advocacy by Australian seniors, surely it is not ‘consumer directed care’?
I would argue that the increasing cost borne by the consumer and greater clarity of the finite allocation of dollars for care is driving this ‘revolt’. None of these reports comment on CDC as it relates to goal setting, meeting of needs/aspirations or achieving the goals of maintaining independence – no, they are all about cost/price.
There is a challenge for organisations to engage with their customers to enable them to understand and appreciate the value of the services offered and hence the charges that reflect this service and/or change their pricing model for defined services, for example do all services require case management?
in-home care – is it just a ‘transaction’?
The controversy over fees to date has focussed it would seem on ‘case management’ and overheads. In CDC the provider is required to outline these fees when invoicing clients.
Firstly I would ask – In what other commercial transactions are businesses required to provide these pricing breakdowns? Does your electrician, gardener or hairdresser tell you their overhead and supplies cost? NO they don’t – and we are still able to make choices about who and where we go for these services.
Why should in-home care be required to disclose these details – what value does it hold? Surely the consumer just wants to know an all up unit price inclusive of these costs. The consumer can still judge the ‘value’ of your price vis a vis a competitor.
Price is however not the only comparison point against which we judge service. There are many other parameters. IF in-home care must be explicit in the components of their charges then their marketing focus on overheads and case management needs to be recast to demonstrate the value of these services to the client. This might mean reframing in-home care as more than a ‘transaction’ or task i.e cleaning, meals etc. to more of a wrap around suite of services tailored to individual needs.
In-home care providers need to promote the benefits of their case management and their service models – what is their value to consumers? To do this successfully it would be useful to know what consumers want and what they see as having value in their in-home care services. This is a great opportunity to talk to and listen to the desires and needs of clients.
Senior advocacy welcome
Having said all this I think it is really positive to see seniors playing a more active advocacy role for themselves. The challenge is to learn from what consumers are telling us, preferably before more negative stories arise in the press.