Aged care reform 2025/26: What providers need to do now

Reform has landed. Now the real work begins

Earlier this week, the new Aged Care Act and Support at Home program came into force, reshaping how aged care operates, funds and proves quality. It is the most significant change since the Royal Commission into Aged Care Quality and Safety.

From 1 November 2025, all providers now operate under a rights-based Act with a stronger regulator and universal provider registration. At the same time, Support at Home replaced Home Care Packages and Short-Term Restorative Care with a single entry model and simpler pricing framework.

These changes aim to strengthen accountability, improve fairness and simplify access to care. But for providers, it is also a whole-of-organisation challenge. Reform affects compliance, finance, workforce and digital infrastructure simultaneously.

For care executives, success now depends on how well you can make reform real – in systems, people and outcomes

From ticking boxes to proving care

Under the new model, the Aged Care Quality and Safety Commission expects providers to show evidence that rights, responsibilities and risks are managed in practice, not just in documentation. That means compliance must shift from being a reactive process to an embedded part of daily operations. Boards and executives need clear visibility over obligations, risks and evidence at any time – not just during audit season.

In short:

Compliance moves from paperwork to proof. Evidence must show outcomes, not intentions.

Governance becomes continuous. Proof is expected in real time, not months later.

Systems connect to people. Policies and training must shape daily workflows.

Visibility replaces volume. Leaders need live dashboards, not long reports.

Data tells the story. Performance is tracked and verified automatically.

The traditional approach – long policies, scattered spreadsheets and annual audits – will not meet this standard. The Commission’s model is built on continuous assurance, where data replaces guesswork and accountability is shared across the organisation. This is where aged care compliance becomes a leadership issue. When staff can see the rule in the workflow, and leaders can see evidence without scramble, the compliance burden turns into confidence.

Four reform realities to act on now

Support at Home: a new standard for transparency

Support at Home introduces a national service list, consistent pricing parameters and stronger consumer protections. It also gives providers more flexibility – but that flexibility comes with risk.

Providers now set their own prices within boundaries. If pricing is unclear or inconsistent, complaints and recoupments will follow.

COOs should test every part of the intake-to-claim process. Check that time and travel rules match real service delivery. Map how budgets and items are explained to clients. Staff need to be able to describe price protections simply and accurately.

Early pilots have shown that clear communication about price and scope reduces complaints dramatically in the first 60 days of operation.

The new Act expects visible leadership

The Act’s Statement of Rights and enhanced regulatory powers raise the bar on accountability. It also introduces universal provider registration with specific conditions for each service category.

CEOs should confirm their registration category, responsible officers and compliance dashboards. Each obligation must have a named owner and up-to-date evidence. Boards should expect monthly visibility across compliance, governance and quality.

The Commission has made it clear that responsibility for compliance now sits squarely with leaders, not administrators.

Co-payments: Clarity builds trust

The government’s co-contribution model, drawn from the Aged Care Taskforce report, moves toward shared funding responsibility while protecting people with low means. For many services, this is a cultural change. It requires new levels of transparency and communication.

CFOs and COOs should:

Publish a short, plain-language fees guide.

Explain how co-payments work and what protections apply.

Record hardship cases and refunds consistently.

Reconcile claims weekly to catch anomalies.

Report fee trends to boards as part of quality reporting.

Good fee management is not just financial hygiene – it is part of governance and consumer trust.

Waiting lists: Data over dashboards

Even with reform, waiting times and access remain major pain points. The latest Home Care Packages Program Data Report shows approvals and assignments still taking months in some regions.

Care managers should:

Replace informal dashboards with verified government data.

Review waiting lists weekly from assessment to service start.

Provide clear, honest updates to families.

Offer interim support where possible.

Escalate changing risk levels promptly.

Transparency builds trust. Guesswork erodes it.

Common missteps in the first month of reform

Policies updated, practice unchanged

It is easy to rewrite policy but hard to change habits. Put short decision aids in the tools your staff already use. Train for the path they take, not the policy you publish.

Variable pricing, variable trust

When pricing varies without explanation, confidence disappears. Publish one clear schedule. Check that claims match what was delivered, and coach staff to handle fee conversations with confidence.

Missing consent, missing evidence

Gaps in consent records are among the top compliance risks. Record consent as structured data that is visible during visits and handovers. Regularly test your ability to export and present evidence on request.

Silence on wait times

Consumers expect honest updates. Use official data to set expectations and document every communication.

Your compliance engine now runs on data

Under the new Act, compliance cannot live in documents alone. It needs to live in data. SognosCare brings aged care reform software built on Microsoft Dataverse, connecting people, visits, incidents, consent and claims into a single record that is consistent and auditable.

Every asset create, update and view is logged through role-based access.

Secure Message Delivery (SMD) and FHIR standards support safe information sharing.

Managed solutions and data loss prevention controls reduce variation.

Evidence is available in real time for audit or review.

Reporting gives boards a single source of truth.

This approach makes compliance part of everyday work. It reduces risk, strengthens governance and gives leaders a clear view of performance across services. When data integrity improves, consumer confidence follows.

Making reform real

Prove one process before scaling.

The most effective providers focus on one high-value workflow and get it right before expanding. A practical starting point is Support at Home intake to first claim. Map the flow, fix the friction, then replicate across teams.

Embed clarity in every screen.

Co-design the intake and handover process with frontline teams. Place the rights summary and price schedule in the same view staff use with consumers. Real-time visibility beats after-the-fact review.

Measure what matters.

Run a four-week pilot and track time from approval to first service and first-pass claim acceptance. These two numbers reveal both compliance maturity and service efficiency.

Build readiness into governance.

Alongside the pilot, complete a registration readiness check. Confirm your category, conditions, evidence and deadlines. Clear ownership early prevents last-minute pressure.

Know when it’s working.

You will know reform is embedded when your board sees a single dashboard linking compliance, claims and client outcomes – and when those numbers tell a consistent story of stability, trust and improvement.

The Sognos difference

At Sognos, we focus on the operating problem, not the paperwork.

Our aged care reform software helps providers meet obligations while improving the daily experience for staff and clients.

Staff see the rule at the moment of care.

Consumers see their rights and fees clearly.

Leaders can prove compliance without the scramble.

If your service is still finding its rhythm under the new Act, we can help you stabilise quickly and build confidence for the next stage of reform.

Book a SognosCare assessment to see how we can help you meet aged care compliance requirements with clarity, efficiency and assurance.