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HIDA 2018 Home Care Market Report

HIDA 2018 Home Care Market Report

The market for home-based medical care (hospice, home health, home infusion, and home medical equipment), was valued at $144 billion in 2017, and is expected to increase 56.3% to $225 billion by 2024. From 2000 to 2016, the number of U.S. HHA visits increased 26% to more than 114 million. Over this time period, the number of HHA providers increased 62.1% to meet growing demand. As the U.S. population continues to age, adding more seniors to the market, home health providers are projected to experience increased volumes.

Medicare, Medicaid 80% Of Home Health Agency Payer Mix
With the largest share of home health agency payments coming from government sources, the industry is considered most vulnerable to legislative changes that would impact reimbursement. However, the industry is conversely insulated from broader economic shifts as fewer payments come from private insurance and self-pay.

• In 2016, Medicare spent $18.1 billion on home health services, and from 2001 to 2016, Medicare margins for HHAs remained flat.
• Medicaid spending on home health and personal care services totaled $60 billion in 2016, 11% of total Medicaid spend.

Hospice Utilization Up 180%, 2000-2016
There were 4,200 hospice providers nationwide as of 2017, with a combined market value of $18 billion. Hospices received an average of 4% of hospital discharges in 2017, and admitted approximately 300,000 patients each quarter beginning in Q1 2017.

From 2000 – 2016, the total number of hospice users increased 180% from 0.5 million to 1.4 million. The majority of hospice patients (95%) are over the age of 65, and half are over the age of 84. In 2017, the most likely principal diagnosis for hospice patients was cancer (27.2%) followed by cardiac and circulatory issues (18.7%), and dementia (18.0%).

Competitive Bidding Adds Pressure To HME Market
The U.S. market for home medical equipment (HME) totaled $51 billion in 2017, and is expected to reach $53.2 billion in 2018. Growth in this market is driven by increased utilization in home care services.

The Durable Medical Equipment Prosthetics Orthotics And Supplies (DMEPOS) Competitive Bidding Program continues to add financial pressure to HME suppliers. As of 2017, suppliers report reimbursements of approximately 80% of the cost of providing products to Medicare beneficiaries. Both suppliers and beneficiaries agree that the program increases difficulty in delivery of HME services and supplies.

The Centers for Medicare and Medicaid Services (CMS) has made a number of changes under the DMEPOS Competitive Bidding Program. The agency has finalized lead item pricing for the program, established single payer amounts using maximum winning bids, and created three temporary payment methodolities that are location-dependent.

Executive Summary
Home Health Market Overview
Home Health Providers’ Top Issues Include Staffing, Reimbursement, And Cost Control
Top Home Health Providers Reported Expenses
Reported Revenues For Top Five Home Health Providers
Aging Population Drives Senior Housing Shortages
Family Caregivers Face Work, Health, Resource Concerns
Americans Expect HHAs To Provide Long-Term Care
Home Health Visits Increased 26.3% From 2000 to 2016
Reported Admissions For Top Five Home Health Providers
Two-Thirds Of Home Health Episodes Not Preceded By A Hospitalization Or PAC Stay
Most Home Health Visits Are For Skilled Nursing, Therapy
Staff Recruitment, Retention Continue To Challenge Home Health Providers
Per-Case Costs Lower For Home Health
Medicare Spending On Home Health Reaches $18.1 Billion In 2016
HHAs Most Dependent On Government Reimbursement
HHA Medicare Margins Remain Unchanged In 2016
Medicare Advantage Patients Less Likely To Use PAC Services
Medicare Advantage Allowed To Begin Paying For Non-Skilled Care
Medicaid Spending On Long-Term Care Services $118.5 Billion In FY 2016
Home Health Spend Per Medicaid Beneficiary Varies By State
Leading ACO Uses Home Health To Create Savings
Patient Home Delivery
Home Health Agencies Highly Fragmented
Home Health M&A Remains Steady In 2017
HHA Investment Expected To Increase, 2018 – 2020
HHAs Perform Well On Quality Measures
Home Infusion Market Dominated By Four Players
Medicare Comprises 88% Of Hospice Payer Mix
Hospice Utilization On The Rise
One-Quarter Of Hospice Users Are Cancer Patients
HME Market Expected To Reach $53.2 Billion In 2018
Most HME Businesses Are Individually Owned, Single Location
HME Suppliers Offer Variety Of Products
HME Suppliers, Beneficiaries Agree: Competitive Bidding Has Weakened Market
Medicare Reimbursements Less Likely To Cover Costs For Smaller Suppliers
GHX Reports $47.2 Billion In Sales Through Distribution In 2017
GHX Reports Home Health Sales By Segment
GHX Reports Top Home Health Product Category Sales Through Distribution

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