Healthcare Market Resources: Hospital Affiliated Agencies’ Monopoly a Myth

New assessments by Healthcare Market Resources (HMR) using 2009 Medicare claims data has disproved the myth that hospital-affiliated home health agencies (HHA’s) hold a monopoly over post-acute home health referrals.

By tracking and comparing hospital inpatient claims to home health admissions, HMR examined which home health agencies patients used after leaving each hospital. HMR concludes that more than 67% of hospitals in the U.S. do not use a dominant home health agency.

“The research goes beyond the boundaries of previous analysis which was limited to examining competition within a geographical area,” explained Richard Chesney HMR CEO. “Our analysis gives insight into the referral patterns established by specific hospitals bringing market share analysis down to the micro level.”

A review of the data in a particular market can reveal that while some of the states in the highest quartile have CON restrictions on access, that regulatory-limited provider base did not automatically lead to a high percentage of “single-agency dominated” institutions.

“Our data analysis can take into account that a hospital may attract patients beyond the service area of the captive agency or even go as far as to make note that in many metropolitan areas, patients can easily cross state lines to get care, while agencies cannot,” Chesney explained. The research identifies the hospitals that have a dominant agency, with more than 70% market share, but this HHA may not be a captive organization.

Healthcare Market Resources offers a glance at the state data used for its analysis with a comprehensive chart here

Written by Erin Hegarty

Erin Hegarty

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