The Alliance provided a submission to the Independent Health and Aged Care Pricing Authority (IHACPA) Consultation on the Pricing Framework for Australian Support at Home Aged Care Services 2027–28.
Pricing equity as a core principle
Without explicit recognition of rural and remote realities, such as distance, lack of scale, workforce constraints, and other unavoidable rural cost differentials, there is a risk that the Support at Home program will entrench existing inequities for older people and exacerbate already fragile service markets.
Cost pressures and access issues in rural Australia (Question 4)
To avoid under-pricing services that are delivered in non-metropolitan settings, IHACPA’s pricing advice must explicitly consider cost pressures in rural areas which are systemic, unavoidable and cross-cutting. This includes considering reinstatement of the human override function for the Integrated Assessment Tool (IAT).
Without policy responses that recognise economic volatility and its disproportionate impact on home-based aged care, the ability of Support at Home to deliver equitable, accessible, and reliable care for senior Australians will be significantly compromised.
The Alliance also emphasises that locally tailored service models are not optional innovations in rural and remote aged care—they are essential to service viability, safety and equity. Recognising that the social, demographic and environmental context of rural Australia vary greatly between locations, policy levers must focus on supporting integrated and place-based planning and delivery of aged care, so that solutions can adequately address local needs, context and barriers.
Supporting service continuity and market viability in thin markets
Pricing advice for thin markets must explicitly include rural and remote loadings that reflect unavoidable cost differentials and travel subsidies or minimum service guarantees to protect access. Failure to do so risks provider withdrawal, reduced choice, and service gaps that disproportionately affect vulnerable older Australians.
Differential impacts across service types (Question 5)
Pricing must recognise and differentiate cost drivers across service types.
Affordability and consumer impacts in rural communities
Pricing and co-contribution settings under Support at Home should not result in reduced service uptake due to higher out-of-pocket costs and disproportionate impacts on services such as domestic assistance, which play a critical role in wellbeing, monitoring and social connection. This is particularly important for older people with specialist needs, such as those with high care needs, dementia or who require culturally safe or culturally appropriate care.
In addition, pricing must not result in increased hospitalisation or premature entry into residential aged care as a result of essential home supports or modifications becoming unaffordable.
Conclusion
With 1 in 3 older people living in rural areas and almost 3,600 providers delivering aged care services in these areas (DHDA, 2026), it is critical that the right policy settings and levers are in place to target additional funding and supports to providers in under-serviced markets. Fair and transparent pricing is essential not only for provider sustainability, but for ensuring that older Australians, regardless of where they live, can age safely, with dignity, and with access to the care they need.