Why home care referrals matter for clinical outcomes
Research consistently shows that appropriate home care support reduces hospital readmission rates, improves medication adherence, and significantly enhances quality of life for older patients. For GPs and hospital discharge planners, timely and appropriate referral to home care services is a critical part of the care pathway.
The referral pathway: My Aged Care
All funded aged care in Australia now flows through the My Aged Care gateway. Clinicians can:
- Refer patients directly through the Health Professional Portal at myagedcare.gov.au/health-professionals
- Provide patients with the My Aged Care number (1800 200 422) to self-refer
- Provide written referral letters that patients can present when they call
What to include in a referral or supporting letter
- Patient's functional status and specific limitations in daily living
- Reason for referral and urgency
- Current medications and any administration requirements
- Relevant medical history and recent changes
- Social situation (lives alone, carer available, etc.)
- Any safety concerns (falls risk, cognitive impairment, etc.)
Commonwealth Home Support Programme vs Home Care Packages
Under the new Support at Home system (from July 2025), these pathways are being integrated. However, assessment still determines what level of support a person is eligible for. For lower-need patients, entry-level services may be available quickly. For complex cases, a higher classification with more funding is appropriate.
Partnering with Lyft Community
Lyft Community is a registered aged care provider serving Melbourne and the Mornington Peninsula. We work collaboratively with GPs, hospital discharge planners, and specialist teams to provide seamless transitions from hospital to home. For urgent discharge support or to discuss a patient, please contact our team directly — we aim to respond within one business day.