Big Room Planning - May 2025

Date: May 2025 Type: Product Team Big Room Planning Session Duration: 60-90 minutes

Executive Summary

Build an all-in-one, scalable care management platform that serves recipients, coordinators, providers, and internal staff with clear, compliant workflows
SAH (Support at Home) reforms materially change pricing, budgeting, and claims—our product and operations need to align ahead of transition
Immediate focus: SAH core workflows (budgets, statements, invoices, claims), coordinator economics/UX, and recipient/admin portal improvements
Change management: New agreements, clear migration communications, and in-portal execution

1. Product Strategy & Goals

Mission

An easy-to-use, end-to-end care platform that supports:

Assigning providers to budgets
Tracking spend/statements
Note-taking
Compliance
Staff and rates management
Billing

Current Scale

10,000+ Recipients
~200 Coordinators
~10,000 Service Providers
~300 Internal Staff

Strategic Aim

Build competitive advantage through tech-enabled operations and streamlined software stack.

Ecosystem Considerations

Aircall
Xero
Microsoft Suite
Employment Hero
Zoho CRM

Business Goals: Build Competitive Advantage

Goal	Competitive Advantage Created
Operational efficiency (AI-enabled CRM → 60% GP)	Lower cost of labour ~60% Gross Profit; harder for higher-cost rivals to match
Reduced SaaS dependency	Cuts per-user fees ⇒ deeper control over roadmap vs vendor lock-in. Bespoke and built for us
Regulatory agility (e.g., Support@Home)	“Robustness” to shift in regulatory. Software ‘sets like concrete’
Data-driven decision-making	Quicker, evidence-backed pivots. Better validation and access to data. AI Overlay
Risk management via data	Trends; Being Preventative vs Reactive. Industry Leading
Compliance & security	Health Care Industry. Strengthens Trust and Governance of Sensitive Information
Scalability & performance	Ability to Scale and Grow into the Market Leader position
Modular / Integration	Faster roll-ups & partnerships; lets you “plug-in” new providers before rivals can
Beautiful user experience	Differentiation that drives retention, word-of-mouth, and premium positioning
Self-service capabilities	Scales support without head-count; raises switching costs as users embed workflows

2. Where We Are Now: Usage & Feedback

Portal Usage Data

40% of portal access via mobile
10% Coordinators
10% TC Employees
65% Representatives
25% Recipients

What Users Like (Positive Aspects)

Respect shown by workers - Highest average rating
Staff kindness - Highly appreciated caring attitude
Communication - Prompt email communication, staff genuinely care
Reliability - Dependable service delivery

Top Improvement Areas

From Recipient CSAT Survey

Accounts and Reimbursements (20.5%) - Delays and inefficiencies in financial processes
Timeliness of Information (18.0%) - Delays in receiving necessary information
Call Experience (14.6%) - Communication clarity and customer service quality
Inconsistent Communication Quality (11.7%) - Inconsistent or poor communication from staff

From Administrator Portal Survey (26 respondents, Dec 2024)

Overall satisfaction: 3.46 out of 5
Ease of use: 3.79
Helpfulness in completing work faster: 3.21
Ease of navigation: 3.46
Satisfaction with support: 3.63

Areas for Improvement:

All bills in the portal to prevent navigating two platforms
Action lists - what bills to action first
Recipient/Coordinator self-serve features (profile management, invoice comments, budget requests)
Note taking, auto save notes and question templates
Improving screen compatibility for smaller laptops
Slowness, loading and search

From Recipient Portal Feedback (23 responses, Dec 2024)

Live Chat ⭐

Request for live chat functionality
Instant questions feature not as useful as live chat
Pop-up window duplication of email functions

Account Info ⭐

CSV export for transactions no longer available
Need flexible financial analysis in Excel
Portal doesn’t actively show current position
Need payment pending list to track invoice processing timeline
Account screens don’t show all details on mobile

Profile Info ⭐

Phone number not listed correctly
Personal details showing incorrect
Essential that info from HCP assessment teams transfers accurately

CSAT Score Comparison (967 SM vs 391 SM+)

Metric	967 SM	391 SM+	Difference
Support Services Availability	8.2	8.7	+0.5
Communication Satisfaction	7.9	8.6	+0.7
Support Level	7.9	8.6	+0.7
Staff Kindness	8.4	9.0	+0.6
Call Experience	7.9	8.3	+0.4
Timeliness of Information	7.7	8.5	+0.8
Respect Shown by Workers	9.1	9.4	+0.3
Staff Explanation Clarity	8.1	8.5	+0.4

3. Recent Portal Releases Highlights

Completed/In Progress

100% Invoices in the Portal + Artificial Intelligence
Recipient Portal - Pending Transactions feature
Budget Proposals functionality

Technology Stack

Microsoft Azure
OpenAI

4. Support at Home (SAH) - Industry Context

Why It Matters

“Once in a Lifetime” reform - Most significant shift in Australia’s home care sector in decades, reshaping pricing, revenue, and regulatory norms.

Key Statistics

Metric	Details
1.4M Participants	1.4 million older Australians will benefit from the program
300k New	300,000 additional people will receive support by 2034-35
$78,000 Max Subsidy	Maximum individual funding increased from $61,440 to $78,000 per year
$9 Billion	Estimated $9 billion+ in annual government funding for home care
2027 Consolidation	CHSP will transition in 2027 under new funding & service models
50% Co-Payments	New co-payment model based on service type & means-testing
15-25k Additional Funds	End-of-Life Pathway: $25,000; AT-HM: Up to $15,000 per client
Quarterly Rollover	Quarterly funding allocations held by Services Australia, limiting rollover

Budget Types - New vs Grandfathered

Existing Home Care Packages (Grandfathered)

HCP Level	Quarterly Funding	Annual Funding
1	$2,708	$10,833
2	$4,762	$19,049
3	$10,365	$41,460
4	$15,713	$62,853

New or Re-assessed Packages

Support Classification	Quarterly Indicative Funding*	Annual Indicative Funding*
1	~$2,750	~$11,000
2	~$4,000	~$16,000
3	~$5,500	~$22,000
4	~$7,500	~$30,000
5	~$10,000	~$40,000
6	~$12,000	~$48,000
7	~$14,500	~$58,000
8	~$19,500	~$78,000

*Final classification dollar values to be confirmed

Additional Pathways

Pathway	Funding Amount*	Funding Period
Restorative Care	~$6,000	12 weeks
End-of-Life	~$25,000	12 weeks

Assistive Technology & Home Modifications

Funding Tier	Funding Allocation*
Low	Up to ~$500
Medium	Up to ~$2,000
High	Up to ~$15,000

Contribution Changes

New Packages - Contribution Rates

Category	Service Type	Full Pensioner	Part Pensioner/CSHC Holder	Self-Funded Retiree
Clinical Care	Allied Health, Nursing, Nutrition, Care Management, Restorative Care	0%	0%	0%
Independence Services	Personal Care, Social Support, Therapeutic Services, Respite, Transport, AT-HM	5%	5% to 50% (income/assets based)	50%
Everyday Living Services	Meals, Domestic Assistance, Home Maintenance	17.5%	17.5% to 80% (income/assets based)	80%

Note: $130,000 lifetime contribution cap applies to contributions in S@H and non-clinical residential care

Grandfathered Packages - Contribution Rates

Category	Service Type	Full Pensioner	Part Pensioner/CSHC Holder	Self-Funded Retiree
Clinical Care	All clinical services	0%	0%	0%
Independence Services	All independence services	0%	0% - 25% (income/assets based)	25%
Everyday Living Services	All everyday living services	0%	0% - 25% (income/assets based)	25%

Scenario - Contribution Comparison (per $100 spent)

Full Pensioner under SAH:

Everyday Living: 17.5% of $40 = $7.00
Independence: 5% of $20 = $1.00
Clinical Care: 0% of $20 = $0.00
Home Modifications/Equipment: 0% of $20 = $0.00
Total Co-Contribution: $8.00 (Previously $0)

Self-Funded Retiree under SAH:

Everyday Living: 80% of $40 = $32.00
Independence: 50% of $20 = $10.00
Clinical Care: 0% of $20 = $0.00
Home Modifications/Equipment: 0% of $20 = $0.00
Total Co-Contribution: $42.00 (Previously ~$5-12)

New Integrated Assessment Tool (IAT)

The new IAT includes 18 sections covering:

Assessment details
Reason for assessment
Carer profile
Social
Function
Medications
Physical & personal health
Frailty
Cognition
Behaviour
Psychological
Medical
Home and personal safety
Financial and legal
Support considerations
Current access to services
Goal setting
Assessor recommendations

5. SAH Operating Model & System Requirements

Service List & Pricing

A defined service list is identified with S@H with 3 categories:

Clinical Support - Contribution Rate: 0%
- Nursing Care (Registered Nurse, Enrolled Nurse, Nursing Assistant, Nursing Care Consumables)
- Allied Health and other Therapeutic Services
- Nutrition (Prescribed Nutrition)
Independence - Contribution Rate: 5% to 50%
- Personal Care
- Social Support and Community Engagement (Group Social Support, Individual Social Support, Accompanied Activities, Cultural Support, Digital Education and Support)
- Therapeutic Services for Independent Living (Acupuncturist, Chiropractor, Diversional Therapist, Remedial Masseur, Art Therapist, Osteopath)
- Respite
- Assistive Technology and Home Modifications
Everyday Living - Contribution Rate: 17.5% to 80%
- Domestic Assistance (General House Cleaning, Laundry Services, Shopping Assistance)
- Home Maintenance and Repairs (Gardening, Assistance with Home Maintenance and Repairs, Expenses for Home Maintenance and Repairs)
- Meals (Meal Preparation, Meal Delivery)

Important: Participants are not automatically eligible for services on the service list. They must be assessed as needing the service, documented in their notice of decision and support plan.

Budget Types in Portal

Support at Home Budget Types:

Care recipient quarterly budget
Restorative care pathway
Assistive technology
Assistive technology specified needs
Home modifications
End of life pathway
Commonwealth Unspent funds draw down
HCP Unspent Funds
Voluntary Contributions

Critical Rule: Budgets can be exceeded but Budget Types cannot!

Spending Notification / Pacing Check

Budgets can be exceeded 100%+
On Hold at 120%
- Month 1 notification
- Month 2 notification
- Month 3 notification

Client Statements

Monthly statements showing:

Budget Summary (Quarterly Budget Allocation, Rolled Over from Previous Quarter, Total Available This Quarter, Total Spent This Month, Total Spent This Quarter, Remaining Balance)
Services Delivered (detailed breakdown)
Participant Contributions
Care Management Allocation
Assistive Technology and Home Modifications (AT-HM)
Unspent HCP Funds
Funds breakdown by budget type

Statement features:

Not an invoice - no payment required
Refers to following pages for service information
Separate invoice for participant contributions
Multi-page format with detailed breakdown by service category

6. Coordinator Model

Coordinator Loading Fees

New Feature: Allow Coordinators to see their earnings

Bar graph shows earnings over time
Financial year tracking
Projected fees vs actual fees vs funding utilization rate

Coordinator Invoice (RCTI)

RCTI Agreement signed outside of Portal
Monthly invoice generated by Trilogy
Broken up by Client
Captures the 20-30% loading on every single transaction
Downloadable statements
GST and total fees clearly shown

Coordinator Markup

Fees are marked up on the Invoice Line Item
Visible in invoice details:
- Service amount
- Estimated Contribution
- Coordinator Loading (marked up amount)
- Platform Loading
- Total Amount including fees

Coordinator Fees Dashboard

Features multiple service fees per coordinator:

Service Coordination classification
Coordinator Loading percentage (e.g., 20%)
Notification and Approval Flows
Ability to edit fees with options:
- Apply new fee rate to new clients only
- Apply new fee rate to existing clients and new clients
- Select discount rate
- Different rates for new vs existing clients

7. Re-Contracting & Change Management

New Agreements Required

New Home Care Agreement
- Aligns with updated service standards and funding models
New Coordination Agreements
- Ensures clarity between consumers, providers, and stakeholders
Compliance & Accountability
- Meets regulatory obligations
Clear Communication Plan
- Proactive engagement to ensure smooth transitions
- Value Management

In-Portal Execution

Trilogy is working to execute Home Care Agreements in Portal with their invite to Portal!

8. Lead Conversion / Customer Onboarding

Onboarding Requirements

Commencement Events (Allow Multiple)

Package Options:

Self-Managed vs SM Plus (Change in Management Option)
Coordination Option
Primary Contact (Lead already has this)

Customer Onboarding Flow

Stages:

Research / Enrich - Lead capture and initial contact
Establish Contact - Phone and web form
Pitch / Qualify - Sales nurture and call cadence
Conversion - Lead to Consumer conversion
Onboard - Care Plan creation, Package setup
Onboard (continued) - Integration and setup
Nurture - Ongoing support

Key dependencies:

Assessment Process
IAT (Integrated Assessment Tool)
Existing Care Plan (if transferring)
Kanyini Number Series
Services Australia integration
HCA (Home Care Agreement) signing
Budget creation
Care Note and Care Event

9. Global Package View Improvements

Time invested to make package view clearer - when you open a package you see key information about the recipient:

Profile Section

Recipient details (title, preferred name, gender, date of birth, age)
Preferred contact method and times
Associated timezone
Login status

Trilogy Care Team

Care Partner
Coordinator (with organization affiliation)
Representative

Contact Information

Preferred contact (Primary representative)
Preferred contact method
Preferred contact time
Language
Requires interpreter status
Email, Mobile number, Home number

Package Information

Trilogy Care ID
Care recipient ID
Package type
Status
Commencement date
Cessation date
Financial status
Tags

10. Governance: Supporter vs Representative

Supporter

Request to System Governor to appoint a support person (e.g., a family member or close friend)
Helps with navigating the aged care system
Can be for a specified term and can be cancelled/suspended at any time
Provides support and may seek information on the person’s behalf
Does NOT make any decisions

Representative

The person may request a Representative to have the power to make aged care decisions for or with them (e.g., if they do not want to make a decision or if their ability declines)
Can be for a specified term and can be cancelled/suspended by the System Governor at any time
System Governor must have regard to certain information when appointing
Particularly where a person is appointed under State/Territory legislation as a Guardian/EPOA, that person will almost always be appointed as a representative
In some cases (e.g., where the person lacks ability to make decisions), the System Governor may appoint a representative nominee to make aged care decisions on the person’s behalf without the person’s consent
The representative nominee can make aged care decisions following a set of decision-making principles that prioritise the person’s wishes and preferences

Nominee’s duties include: Ascertaining the wishes of the person; acting in a manner that promotes the person’s personal, cultural and social wellbeing; maintaining the decision-making ability of the person; avoiding/managing any conflicts of interest; and complying with any other duties under the legislation.

11. Service Provider Directory Vision

Features to implement:

Search filters - Categories, Package level, Location, Price Range
Service provider profiles - Business details, services offered, pricing, availability
Results display - Ratings, reviews, location, services, pricing, schedule flexibility
Closest match indicators
Sorting options - Most Relevant, per page limits
Applied filters display with clear all option

12. Additional Features

Attachments & Care Timeline

Documents section with file upload
Document type tags
Additional information timeline
Internal only notes option
Tagged entries with user and timestamp

Composable Workday

Identified CRM Gap Workflows:

Ticketing System (considered and tagged against packages/supplier)
Cab Charge
Assessments
Supplement Applications
Change in Level

13. Program Overview (July 2025 Timeline)

Entry Points

My Aged Care - Single entry point with Assessment Outcome
Advisory Services - For Dementia, Vision, Continence (don’t require aged care assessment)
Other Aged Care Programs
CHSP - For low level needs (operates until 2027)

Short Term Support

State-based loan schemes
Assistive Technology and Home Modifications (ATHM)
End of Life Palliative Support
Short Term Restorative Pathway

Ongoing Services (July 2025)

Single Provider initially - All services through single provider who also sources short term support
Classification and Quarterly Budget
Services delivered based on Support Plan Details
Adjusting Services - Can be adjusted within quarterly budget; older people can save up to $1,000 between quarters
Optional Budget Pooling - Option for client budgets to be pooled (e.g., onsite nurse in retirement village)

Financial Flow

Payments flow between provider and Services Australia
Service and Price Lists - Providers invoice against service list with price caps set by Government
IHACPA - Independent Hospital and Aged Care Pricing Authority provides advice on efficient prices

Care Partner

Qualified person checks older person’s outcomes
Helps organize any changes needed
Initially provided by service provider
Later, older person may choose independent care partner

Thin Market Grants

Supplementary grants to service providers in thin markets or delivering additional social benefit.

14. Post July 2027 Changes

Key Differences

No CHSP - CHSP program fully transitioned
Limited Time Home Help - New short-term support category added
Multiple Service Providers - Older people can use one or number of support at home providers
Care Partner Choice - The older person may choose a care partner who works for their service provider or is independent

15. Priorities & Actions (BRP Focus)

A. SAH Compliance & Core Workflows

Implement budget types and validation
Build client statement generation
Create invoice workflows with budget type allocation
Services Australia API integration
Claims process automation

B. Re-Contracting & Change Management

New Home Care Agreement template
New Coordination Agreement template
In-portal agreement execution workflow
Communication plan for existing clients
Migration timeline and approach

C. Coordinator Economics & UX

Coordinator fee summary dashboard
Monthly RCTI generation
Fee configuration interface
Notification and approval workflows
Multi-service fee support

D. Recipient & Admin Portal Improvements

E. Onboarding & Package Clarity

Lead conversion workflow improvements
Multiple commencement events support
Package options selection (SM vs SM Plus)
Coordination option selection
Global package view enhancements
Key recipient information surfacing

F. Directories, Governance & Ops Gaps

Service Provider Directory (profiles, filters, search)
Supporter vs Representative governance model
Ticketing system implementation
Supplier CRM workflows
Workflow automation for common tasks

G. SAH External Context to Monitor

Track regulatory updates and guidance
Monitor Services Australia API changes
Review contribution calculation updates
Follow budget type and pricing changes

BRP Session Agenda (60-90 min)

Context & Goals (10 min) - Strategy, SAH implications, success metrics
Current Feedback (10 min) - What to fix now vs later
SAH Core Workflows (25 min) - Budgets, statements, claims
Coordinator Economics & Portal UX (15 min) - Dashboards, RCTI, self-serve
Change Management (10 min) - New agreements & comms
Prioritisation & Owners (10-20 min) - Lock scope for next 4-6 weeks

Success Metrics

Experience

Portal satisfaction ≥ 4.2/5
Search success ≥ 85%
Mobile task completion ≤ 2 mins for top flows

Throughput

≥ 95% invoices visible in portal within 24h
≥ 90% claims API success on first attempt

Financial

Reduce software spend by X% YoY
Coordinator billing accuracy ≥ 99%

Change

≥ 90% of active clients on new HCA within N weeks of launch

Owners & Timeline

To be confirmed in BRP:

SAH Core Workflows: Owner __ / Eng Lead __ / Target __
Agreements & Comms: Owner __ / Legal/CS __ / Target __
Coordinator UX & RCTI: Owner __ / Eng Lead __ / Target __
Portal Improvements: Owner __ / Design __ / Target __

Risks & Dependencies

External Risks

External policy/timing shifts
Services Australia API dependencies
Regulatory changes or delays

Internal Risks

Data migration risks
Capacity constraints
Mobile responsiveness complexity

Dependencies

Legal review of new agreements
Services Australia API access and documentation
User testing and feedback cycles

Next Steps

Confirm scope/owners in BRP - Assign clear ownership for each priority area
Translate priorities into epics/stories - Create detailed user stories with acceptance criteria
Stand up weekly burn-up/metrics review - Track progress against success metrics
Begin stakeholder communications - Prepare messaging for re-contracting and SAH changes
Establish migration plan - Timeline and approach for transitioning existing clients

References

Big Room Planning Presentation (May 2025)
Consumer Satisfaction Survey (Self Managed) - 967 responses
SM Plus Consumer Experience Survey - 391 responses
Portal Survey - 26 respondents (Dec 2024)
Hotjar Recipient Responses - 23 responses (Dec 2024)
Support at Home Program Documentation
Services Australia resources