Set up to fail: Explaining systemic problems in the business model of in-home aged care

Rachael L. Lewis; Gillian McAllister; David A. Brown; Olivia Rawlings-Way; Nicole C. Sutton; Celina McEwen; Deborah Parker; Nelson Ma

doi:10.1177/03128962241309407

Set up to fail: Explaining systemic problems in the business model of in-home aged care

Rachael L. Lewis
, Gillian McAllister
, David A. Brown
, Olivia Rawlings-Way
, Nicole C. Sutton
, Celina McEwen
, Deborah Parker
, Nelson Ma

University of New South Wales
University of Technology Sydney

Research output: Contribution to journal › Article › peer-review

Abstract

We seek to explain the role of external environmental constraints in embedding systemic problems within a dominant industry business model. Using qualitative data from the 2019–2021 Australian Royal Commission into Aged Care Quality and Safety, we show how three sector-wide constraints – channel constraints, revenue constraints and resource constraints – impinge on the business model for in-home aged care services, creating direct, first-order effects by embedding systemic problems directly within business model components. We also explain how second-order effects occur through interdependencies with other business model components. We discuss the consequences of our findings for value creation and value capture, and the implications for the delivery of quality care to older people. Through this analysis, we also contribute to the business models literature by extending our understanding of the impact of external factors on business model performance, innovation and managerial choice.

Original language	English
Pages (from-to)	117-146
Number of pages	30
Journal	Australian Journal of Management
Volume	51
Issue number	1
DOIs	https://doi.org/10.1177/03128962241309407
Publication status	Published - Feb 2026
Externally published	Yes

Bibliographical note

Publisher Copyright:
© The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 9 Industry, Innovation, and Infrastructure

Keywords

Aged care
business models
quality
value capture
value creation

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10.1177/03128962241309407

Cite this

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title = "Set up to fail: Explaining systemic problems in the business model of in-home aged care",

abstract = "We seek to explain the role of external environmental constraints in embedding systemic problems within a dominant industry business model. Using qualitative data from the 2019{\textendash}2021 Australian Royal Commission into Aged Care Quality and Safety, we show how three sector-wide constraints {\textendash} channel constraints, revenue constraints and resource constraints {\textendash} impinge on the business model for in-home aged care services, creating direct, first-order effects by embedding systemic problems directly within business model components. We also explain how second-order effects occur through interdependencies with other business model components. We discuss the consequences of our findings for value creation and value capture, and the implications for the delivery of quality care to older people. Through this analysis, we also contribute to the business models literature by extending our understanding of the impact of external factors on business model performance, innovation and managerial choice.",

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note = "Publisher Copyright: {\textcopyright} The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).",

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doi = "10.1177/03128962241309407",

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AU - Lewis, Rachael L.

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AU - Brown, David A.

AU - Rawlings-Way, Olivia

AU - Sutton, Nicole C.

AU - McEwen, Celina

AU - Parker, Deborah

AU - Ma, Nelson

N1 - Publisher Copyright: © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

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AB - We seek to explain the role of external environmental constraints in embedding systemic problems within a dominant industry business model. Using qualitative data from the 2019–2021 Australian Royal Commission into Aged Care Quality and Safety, we show how three sector-wide constraints – channel constraints, revenue constraints and resource constraints – impinge on the business model for in-home aged care services, creating direct, first-order effects by embedding systemic problems directly within business model components. We also explain how second-order effects occur through interdependencies with other business model components. We discuss the consequences of our findings for value creation and value capture, and the implications for the delivery of quality care to older people. Through this analysis, we also contribute to the business models literature by extending our understanding of the impact of external factors on business model performance, innovation and managerial choice.

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KW - quality

KW - value capture

KW - value creation

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Set up to fail: Explaining systemic problems in the business model of in-home aged care

Abstract

Bibliographical note

UN SDGs

Keywords

Access to Document

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