Andre Smith is the founder of Carevo, which connects Australian families with aged care and disability providers. Providers pay Carevo a flat subscription; families pay nothing.
I’ve spoken to many in aged care. I have been hearing for years that plenty of providers are registered for CHSP but do not really take CHSP clients, because the money is thin next to a home care package. Everyone inside the sector seems to know this. Nobody publishes it, because there is nothing to publish. A provider does not advertise the clients it turns down.
I run Carevo, a platform where families describe the care they need and matched providers are notified, with 72 hours to claim the request. That gave me a way to check whether she was right.
Here is why the platform can see this at all. When a request arrives, our matching sends it to the same pool of aged care providers whether the person is on CHSP or a home care package. Same providers, same suburbs, same email. The only thing that differs is the funding attached to the person asking. Between 1 April and 5 July this year, CHSP requests reached a median of 53 providers and home care package requests reached 55. For practical purposes, the same audience.
So whatever happens next is not a question of who was available. It is a question of who they picked.
Of 2,826 requests in that window, 243 were never answered, not answered late and not declined. No response at all before the window shut. And when providers did want the work, they were quick about it. Median time to the first response was 2.4 minutes. Fifty-nine per cent of requests were claimed inside five minutes. Nobody is sitting on these for a week. They open the email, they read it, and they decide.
“Then there is the part that sent me back to check the query three times.”
Where only a handful of providers are within reach of a request, CHSP and home care package clients are ignored at the same rate. Under 25 providers notified: 38.5 per cent of CHSP requests unanswered, 37.0 per cent of home care package requests. Effectively identical. Thin is thin, and in those towns the funding label makes no difference because there is genuinely nobody to take the work.
Where there are enough providers to have a choice, the two pull apart.
At 50 to 99 providers notified, 2.6 per cent of home care package requests went unanswered, against 10.0 per cent of CHSP requests. At 100 to 199 notified, 2.1 per cent against 5.5 per cent. Same pool, same week, same platform, and roughly four times the chance of hearing nothing back if you are the CHSP client.
The shape of that is the whole finding. Scarcity does not produce the gap. The gap opens up only once providers have room to choose, and what they choose is the package.
I could not find that anywhere in public data, because public data cannot see it. The department can tell you how many providers are registered for CHSP. It has no field for the client a provider was offered and quietly let expire. Registration is a licence. It is not a promise to answer the phone.
I want to be careful about what this accuses people of, which is nothing. It does not show providers behaving badly. It shows them behaving rationally. Under Support at Home, the distance between a package client and an entry-level CHSP client, in hours and in revenue per visit, is wide enough that when both land in the same inbox at the same minute, the decision makes itself. If I were running a provider with a full roster and two requests in front of me, I suspect I would do what they do. The behaviour is not the problem. The economics underneath it are.
Which leads somewhere uncomfortable for policy. If CHSP access is the goal, registering more providers will not deliver it. The providers are already registered. They are already getting the requests. They are passing on them in under three minutes. A declination problem cannot be fixed with a recruitment strategy. You have to change what a CHSP client is worth to the person making the call.
There is a smaller finding underneath, and operators should sit with it. Of every request we send out, only about 3 per cent of notified providers claim it. Whatever else is true about this market, being quick is still the cheapest advantage on offer. Whoever opens the email in the first five minutes takes the work.
Some caveats, because the numbers have earned them. Funding type is inferred by our classifier from what the family tells us, not verified against a government record. Our aged care pool is a few thousand businesses, not the country. And a request going unanswered with us does not prove the family never found care somewhere else. I am reporting what providers did when we put the work in front of them, and nothing beyond that.
On that narrow question, though, the data is not ambiguous. When there is a choice to be made, the CHSP client is the one left waiting.
