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Our Take

Finding home health providers’ place in the home-based care boom

Three strategies for home health providers to grow revenues

Home-based care experienced an uptick in interest during the Covid-19 pandemic, but home health providers are not seeing the same gains as other providers of care in the home, like hospital-at-home and home-based primary care.

Nevertheless, home health providers have an opportunity to take advantage of the home-based care boom to grow their businesses. Read on to learn how.

What is the difference between home health and home-based care?

Home-based care encompasses several different types of care in the home serving a wide variety of patient populations. These models of care include hospital-at-home, home-based primary care and home infusion. Some of these services are covered by insurance and others are not.

Home health, also referred to as Medicare-certified home health or traditional home health, is post-acute care provided in the home according to Medicare regulations. Patients must meet specific criteria to qualify for home health services to be covered by Medicare.

For a complete overview of the different types of care in the home as well as analysis of their expected growth potential, see our Home-Based Care Market Scan.

 

The conventional wisdom

Due to the Covid-19 pandemic, many hospitals took a “home-first” approach to discharge planning in order to preserve hospital capacity and keep patients safe from outbreaks in post-acute facilities. This strategy pushed the health care industry to invest in delivering new types of care in the home setting, and increasing the acuity level able to be cared for at home. These investments lay the groundwork for growth in home-based care even beyond the pandemic. Providers may make the assumption that as home-based care gains traction, traditional home health organizations will naturally grow alongside other types of home-based care.

However, different types of home-based care will experience growth differently. In fact, much of this expansion is occurring outside of traditional home health, in models like hospital-at-home and home-based primary care. These types of care are markedly different from home health. For instance, hospital-at-home involves different patient types, staffing, timing of visits, and services from traditional Medicare-certified home health. Because these types of care are entirely dissimilar, a boom in hospital-at-home does not automatically translate into growth for home health, leading to frustration and disengagement among home health providers who may struggle to capture any gains.

 

Our take

Despite the growing interest in home-based care, home health’s growth is likely to be smaller than the growth we expect for non-traditional home-based care.  This is primarily due to Medicare’s strict parameters governing home health eligibility, including the requirement that Medicare patients must be deemed home-bound to receive home health.

Additionally, home health is beyond the reach of many patients who need significant assistance with ADL and do not have family caregivers available, or cannot afford the out-of-pocket costs of ADL assistance. These patients will likely continue to need to be cared for in a facility-based setting. 

However, there is still hope for Medicare-certified home health providers to capitalize on the health care industry’s focus on care in the home. Providers can take advantage of this interest in three ways: 

  1. Advocate for hospitals to divert more post-acute care from facilities to the home.
  2. Partner with a home-based care provider to fill service gaps.
  3. Build an innovative home-based care model beyond the traditional boundaries of home health.

Each strategy has different benefits and drawbacks and will be right for different organizations. Organizations can select one or multiple strategies to pursue simultaneously, as shown across the following pages.

 

Taking advantage of the home-based care boom as a home health provider

The three strategies home health providers can take to capitalize on the interest in home-based care are outlined on the following pages. 

 

  • Strategy

    Advocate for hospitals to divert more post-acute care from facilities to the home

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  • Strategy

    Partner with a home-based care provider to fill service gaps

    Read More Collapse
  • Strategy

    Build an innovative home-based care model beyond the traditional boundaries of home health

    Read More Collapse
 

Parting thoughts

Home health providers cannot expect that the increased interest in home-based care will automatically convert into growth for home health. Instead, they must take an active role in carving out space for themselves.

Home health providers are at an important crossroads. As long-time experts in providing care in the home, they have significant opportunity to use their expertise in new ways. However, they cannot assume this growth will occur organically. Rather, they must strategically decide how to take advantage of the industry’s interest in the home. Using the strategies outlined here, home health providers will set themselves up for future growth as more care shifts home.

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