In this context, the main challenges are to reorganise the system to improve efficiency incentives, to reduce further the dependence on institutional care, and to better target patients as the rapid uptake in the cash benefits system has exposed screening problems. As they face no financial risk on care purchase (Box 4), purchasing agencies are not inclined to bargain with care providers on price and quality. In the home care sector, this has led prices to stay very close to the regulated maximum tariff.