The home healthcare industry is in the midst of a rapid expansion, driven by an aging U.S. population. The senior citizen demographic (65 years or older) will reach 16.9% of the total U.S. population in 2020, and is expected to continue rising—forecasted to reach 20.6% by 2030. Coinciding with this population shift comes the likelihood of needing to care for the people who fall within the very age demographic most frequently suffering from chronic diseases.
Given this shift, Definitive Healthcare surveyed 159 home healthcare agency (HHA) leaders in its first-ever Home Health Agency Study in order to uncover the most common services areas, lines of specialized care, and future plans for strategy and development. HHA executives and leaders across 38 different states responded to the online-based survey in October 2019. Here are the main findings:
1. A rise in telehealth technologies
Telehealth is gaining popularity in the long-term care market because it enables care teams to manage and monitor the health of chronically ill patient populations. Access to these technologies can help prevent serious health issues from arising, and may allow for the potential expansion of HHA geographic areas of care.
In the Home Health Agency study, 24% of respondents stated that they are planning to expand their telehealth offerings within the next two years. This, added on top of the 20.8% of agencies that currently utilize telehealth technologies, would mean that 48% of respondents anticipate using telehealth offerings by 2021— more than double this year's current rate.
HHAs currently employ remote patient monitoring, and medication management technology at greater rates than both inpatient and outpatient organizations, based on another Definitive Healthcare study on telemedicine inpatient and outpatient usage. Most notably, two-way video/webcam technologies are currently used the most frequently across the three verticals.
Cost and ease-of-use may be the main contributors to the different strategic approaches for HHAs. Additionally, the HHA patient demographic trends older— showing a greater need for medication management and remote patient monitoring technologies.
Home Health Agency Telehealth Utilization: Current and Future Installations
Figure 1: Definitive Healthcare's Home Health Agency Study (2019), telemedicine utilization and future plans for installation
2. A need for specialized care
The Centers for Medicare and Medicaid Services (CMS) announced earlier this year that, starting in 2020, Medicare Advantage plans will further expand coverage for patients with chronic diseases or conditions. Per the U.S. Bureau of Labor Statistics (BLS), the home healthcare industry is forecasting a 36% employment growth rate by the year 2028, adding an estimated 1 million jobs in the process—a projection that could easily be outpaced, given the recent CMS announcements.
Knowing this, it is of little surprise that 43% of respondents from the 2019 Home Health Agency Study are planning to expand their service offerings within the next two years. This includes specialized care service areas, which focus on the treatments of specific (often chronic) disease states and conditions.
Within two years, 73% of responding organizations indicate that they will either expand, or initially enter into specialized care. Based on this study, disease states or conditions showing the greatest rate of expansion in the immediate future are palliative care, veteran-specific care, and mental health services.
Home Health Agency Specialized Care Offerings
Figure 2: Definitive Healthcare Home Health Agency Study (2019): specialty care offerings and plans for future installations.
3. Staffing and profitability will become increasingly challenging
As the Home Health Agency market continues to grow and expand, it is not surprising that the need for finding and hiring qualified staff tops the list of greatest challenges. Over 60% of organizations identified the issue as a challenge for their organization—a 20% difference from the next closest top challenge: profitability.
With the baby boomer generation continuing to phase into the age demographic which suffers the most from chronic conditions and diseases, the need for acquiring qualified staff may remain a top issue in the Home Health Agency environment for the foreseeable future.
Telehealth platforms may also relieve some of the strain from healthcare staffing shortages by connecting patients to remote providers and keeping patients in network.
2019 HHA study round-up (infographic)
Figure 3: An overview of the Definitive Healthcare Home Health Agency Study (2019)
Definitive Healthcare’s platform offers insight into over 16,000 U.S. Home Health Agencies, including contact information of HHA executives and leadership, quality metrics, claims broken down by HHRG codes, affiliations with physician groups, ambulatory surgery centers and other institutions, and episodes of care data. With Definitive Healthcare's platform, users can:
- Understand the continuum of care: Compare referrals to and from HHAs to understand relationships with hospitals. Look up the percentage of referrals originating from a specific hospital, and whether that hospital is part of a larger IDN.
- Measure quality of care: Access HCAHPS star ratings on an HHA’s overall care quality. See whether patients got better at bathing or getting in and out of bed, as well as how often patients had less pain when moving around.
- Analyze care leakage: Examine cases where patients of one HHA seek treatment at other HHAs for specialized treatments. Find leakage by facility or diagnosis code.
- Review payer mix analyses: Identify the percentage of payments originating from Medicare and Medicaid as well as commercial payors such as TRICARE, Aetna, and BlueCross BlueShield.