As regional aged care fractures, a new study suggests community-owned cooperatives offer a realistic route to restoring local care.
In rural and regional Australia, too many older residents are being uprooted from the communities they helped build, simply to access basic care.
Facilities are closing or scaling back, operators are withdrawing from thin markets, and families are left with no choice but to relocate ageing parents hundreds of kilometres away.
Now, a major national evaluation by Monash Business School’s Mutual Value Lab (MVL) has identified a practical alternative.
The research team, including Associate Professor Paul Thambar, Professor Matthew Hall and Dr Liyan Zhang from the Mutual Value Lab and Dr Sarah Adams (ANU), carried out a two-and-a-half-year independent assessment of the Care Together program.
Designed and delivered by the Business Council of Co-operatives and Mutuals (BCCM) and funded by the Australian government’s Department of Health, Ageing and Disability, the program shows how cooperative, community-owned models provide a workable blueprint for restoring social care in regions where conventional providers have repeatedly fallen short.
“Workforce shortages, small provider exits, and demographic pressures are pushing essential services to breaking point, and traditional market and charity-led models are struggling to remain viable,” Associate Professor Paul Thambar said.
“Our research demonstrates that the cooperative model could provide an alternative business model for social care services because it is structured to support these communities, delivering tangible benefits for residents.”
Testing a new approach
The Care Together program was established to test whether locally owned and governed organisations could fill the widening gaps left by market failure in rural and remote aged care.
From early 2023 to mid-2025, Monash researchers evaluated the program across multiple communities, conducting 49 interviews, attending workshops, and examining program records to track progress.
Their findings identified four cooperative models, each addressing different regional challenges.
“Each model demonstrates how communities can reclaim control, strengthen service continuity, and address workforce and system gaps in ways conventional providers cannot,” Prof Hall said.
Worker cooperatives: Empowering independent care staff
Rural care workers often face isolation and limited professional support.
The Eurobodalla Community Care Cooperative (ECCC) brings independent workers together, providing peer networks, training, leave coverage, administrative support and compliance guidance.
Pooling resources gives members bargaining power and reduces regulatory burdens while maintaining autonomy.
Supported through Care Together facilitation and seed funding, ECCC aims to retain local staff, keep older residents in their communities, and strengthen continuity of care.
Community sector worker Michelle Lloyd said the model creates possibilities that have long been out of reach for many frontline staff.
“What excites me is the potential for people to have true access, true choice and true control of their own lives.” Ms Lloyd said.
Network shared services cooperatives: Keeping small providers afloat
Small providers are the backbone of regional aged care, yet rising compliance and administrative pressures threaten their survival.
In the Murrumbidgee region, eight providers have joined a shared services cooperative, pooling finance, IT, recruitment and compliance functions previously accessible only to large metropolitan providers.
The model also fosters collaboration, planning and knowledge exchange, helping members navigate regulatory complexity.
Facility manager Karen Hodgson said the cooperative gives small sites influence they have long lacked.
“This co-operative will allow us to be a bigger voice in a big pool,” Ms Hodgson said.
Community cooperatives: Navigating care locally
Many older Australians struggle to navigate fragmented services across aged care, disability and mental health.
Cooperative Care Wagin (CCW) addresses this through a locally owned navigation hub connecting residents to the right support, drawing on professional and volunteer networks for flexible, community-driven assistance.
CCW chair Wendy Pederick said the approach mirrors the way regional communities naturally organise themselves.
“People band together around a common interest and a common need and make something happen,” Ms Pederick said.
“To do that you need to harness the abilities and the strength and the interest of the community. What we’re pioneering is care services through a co-operative model.”
National shared services cooperative: Supporting small providers
Small rural care providers often lack affordable back-office services, limiting their capacity to deliver quality care.
Mutual Care Ltd aims to address this by brokering shared recruitment, finance and compliance services, reducing costs and preserving local identity.
Care Together Program Director Gillian McFee said communities had made clear that shared support structures are critical.
“From the work we have done with communities, there is a vision that some form of shared services is actually essential to maintain the viability of care services in regional, rural and remote Australia,” Ms McFee said.
Next steps: Scaling success
The Care Together program has now entered a 12-month extension to support existing projects, build governance capability and scale models showing early promise.
This phase will provide continued facilitation and seed funding, giving cooperatives time to stabilise and demonstrate their potential for national rollout.
BCCM chief executive Melina Morrison said the early results reinforce a fundamental truth about rural service design.
“Communities know what’s best for them when it comes to the care they need and how the services should be delivered,” Ms Morrison said.
“The benefits are obvious, happier and more cohesive communities, more productive and efficient services, and empowered and vocationally satisfied care workers.”
