Australia's aged care bosses are calling on the federal government to "radically redesign" the sector, as its residential facilities are forced into the red and people die on home care package wait lists.
A report, presented to the royal commission on Monday, found about 120 chief executives said there is need for a cabinet minister whose sole responsibility is ageing and aged care reform.
They also supported the possibility of a digital "passport" for aged care recipients, and the immediate evaluation of the sector's viability as financial strain on providers resulted in huge shortcomings in their performance.
"We've done modelling that would suggest $1.3 billion over the next 18 months would bring stability and confidence to the residential aged care sector," Leading Age Services Australia chief executive Sean Rooney said.
The peak body, which collaborated with accountancy firm Grant Thornton to produce the report, has also suggested a cash injection of $500 million every year, for the next three or more years, should be introduced to reduce home care package wait lists of about 130,000 people nationally.
"[The money should be given before the royal commission ends] because we know that [finances] are constraining ... the ability of providers to consistently meet the care needs of residents in residential care, and we know that there is a very human cost of the wait list [for home care]," Mr Rooney said.
On Friday, the government announced a six-month extension to the aged care royal commission until mid-November 2020.
As of March 31, 2019, there were 1690 people in the ACT waiting on a home care package at their approved level. More than 95 per cent had been approved for Commonwealth home support.
Of the 1690 people, 922 had not been offered a lower level home care package, while 10 people had not been offered any assistance.
The royal commission has heard that more than 16,000 Australians died waiting for a home care package in 2017-18.
The chief executives interviewed for the 'Perspectives on the future of ageing and age services in Australia' report called for older people in the system to be able to access services outside of clinical care with more ease.
The aged care sector should be better integrated, the bosses said, and properly incorporate allied health services including hospitals and GPs, affordable housing, and mental health services.
Digital passports could see data shared among providers to determine warning signs of decline and flag opportunities for preventative intervention.
"[It's about] supporting the growing number of older Australians to age well, rather than expecting them to turn up to a ... system that is focused on clinical care," Mr Rooney said.
"Look at this as a social contract between the community, the aged care sector and the government."
The government's aged care portal, My Aged Care, had "poor functionality" and was hindered by some providers' inability or unwillingness to keep their data up to date.
Workers needed to be better paid and time concessions given so they could be better trained. The government was seen as "overly regulating" and "creating red tape" that did not add value to the sector or older Australians' experiences.
"Providers would prefer a shift in perspective from compliance, 'ticking boxes', to real feedback on the quality and safety of care," the report said.
Chief executives were unanimous in their commitment to improve the performance of the aged care sector as a whole, as well as their own services.