Aged care reform has landed, but this is only the beginning

The commencement of the new Aged Care Act on 1 November marks a significant milestone in Australia’s aged care journey. But it is not the destination. As highlighted at the recent CEDA Charting the Future of Aged Care event, this moment should be seen as the beginning of a deeper transformation, one that must be shaped by the lived realities of older Australians and the diversity of providers who support them. The discussions reflected both optimism about the direction of reform and realism about the scale of the task ahead.

The small-provider reality

It is often assumed that Australia’s aged care landscape is dominated by large national providers. The reality is far more fragmented. Approximately 60 per cent of the 730+ residential aged care providers operate a single service. While these community-rooted organisations are vital to local care ecosystems, they often lack the scale for robust governance, data systems or compliance infrastructure.

Policy reform and regulatory design need to be alive to that diversity, ensuring that regulatory obligations protect older Australians without unintentionally creating barriers that drive smaller, community-based organisations out of the sector. That balance, between safeguarding quality and supporting sustainability, will continue to be central.

Interpersonal harm and the hidden risks of congregate care

The Aged Care Quality and Safety Commission receives more than 60,000 serious incident reports annually, with half involving resident-on-resident violence. This is one of the least discussed but most confronting realities of care in congregate settings.

Reducing this risk will require more than regulatory enforcement. It calls for an industry-wide shift in how we understand safety, from a compliance obligation to a culture of relational care. It also requires deeper collaboration across aged care, health and mental health services to ensure the right supports are available before incidents occur.

Support at Home transition risks

The rollout of Support at Home under the new Act introduces pricing and funding changes that pose risks to consumers. Older Australians may face higher out-of-pocket contributions for everyday services like cleaning and gardening, which may lead to a reduced uptake of these supports and increased reliance on clinical care. Without clear communication and safeguards, there is a real risk that older Australians will forgo essential services due to affordability concerns or lack of clarity about entitlements.

Addressing ageism

As aged care reform moves from reform to transformation, the sector must work towards deeper cultural and structural shifts required for lasting change. This will shape not just how care is delivered, but how older Australians are valued and supported in the years ahead.

Ageism remains one of the most pervasive barriers to reform. Older Australians are too often viewed as passive recipients of care rather than active contributors to their communities. Recognising the individuality, diversity and dignity of older people is central to delivering person-centred care. This means shifting the narrative—from dependency to agency—and embedding respect and inclusion into every aspect of service delivery, workforce culture and policy design.

Integrating services and addressing the complexity of productivity

The future of aged care lies in seamless integration across systems: aged care must no longer operate in isolation from health, disability, housing, prevention and community services. This enables smoother transitions between home, hospital and residential care, and more coherent support across the ageing journey.

This is one of the key factors to improving productivity in the care economy and achieving better outcomes with the resources we have. As the Productivity Commission’s August 2025 paper suggests, further work is required to align regulation across aged care, disability and veterans’ services, invest in prevention, integrate services and embed collaborative commissioning to reduce fragmentation and improve outcomes. For regulators, the challenge is to drive efficiency without compromising on dignity, safety and quality of life.

Embedding rights-based regulation through inclusive communication

The new Aged Care Act introduces a rights-based regulatory framework that includes a Statement of Rights, strengthened Quality Standards, and a sector-wide commitment to continuous improvement. This approach reframes regulation as a tool for empowerment, placing dignity, safety and consumer voice at the heart of aged care governance.

However, embedding these principles into practice requires more than policy. They demand clear, inclusive and proactive communication with residents, families and staff to ensure that everyone understands their entitlements, the changes underway and how to navigate the system. Communication is foundational to trust, cultural change and the successful implementation of reform.

Reform as a continuous journey

As the Commonwealth Minister for Aged Care Sam Rae rightly noted “the reforms we have introduced are not the destination but the beginning”. The regulatory system is evolving, the funding model is being tested, and the expectations of the community are higher than ever. Older Australians are living longer, with more complex health needs, and they expect services that are respectful, responsive and integrated.

For those in the sector, the work ahead is to stay close to the lived reality of residents. Providers should listen, learn and adapt. The reform has landed. The work of embedding it, improving it and ensuring it delivers for older Australians begins now.