Home Health Continues to Gain Steam Despite Projections of Down Admissions

Despite expectations that home health admissions in the U.S. would drop in Q3 2018, both home health admissions and utilization continued to increase slightly quarter-over-quarter.

Meanwhile, Centers for Medicare & Medicaid Services (CMS) data shows hospice utilization rose to record-breaking levels in the third quarter of 2018, while hospice admission growth declined slightly.

The findings come from the latest quarterly trends report from Atlanta-based analytics and metrics firm Excel Health, which offers cloud-based data solutions for post-acute care providers.


“Home health admissions and utilization continue to increase even after the 2017 bump we attributed to a difficult flu season,” according to the report. “We expected that home health admissions would drop in the early days of 2018, but that proved not to be the case and we still see an increase.”

Home health admissions saw year-over-year growth of about 0.8%.

Home health utilization grew by less than 0.1%.


In the hospice space, the utilization rate rose above 50% for the first time since Excel Health began reporting on the care segment in 2017. While hospice admission growth declined slightly, the industry continues to grow steadily at a rate of 4.2%, likely buoyed by a relatively stable regulatory landscape and demand for hospice services.

“Hospice admissions are seasonal in nature, and third quarters are generally the lowest volume quarters for new admissions [and] benefit elections,” the report reads.

Other highlights from the report, which summarizes the most recent data released from CMS, include Medicare Advantage beneficiaries increasing by 3% quarter over quarter. Additionally, according to the report, a large portion of patients (50%) discharged from the hospital still receive no post-acute care (PAC).

That point is primed for change under the Patient-Driven Groupings Model (PDGM), which has higher levels of reimbursement for patients coming from an institutional setting compared to those coming from the community.

“We believe that this gap from hospital to PAC represents the main reason why hospital readmission continues to be higher than it should be,” the report reads, noting that the figure remains largely unchanged from the previous quarter.

Meanwhile, Medicare free-for-service beneficiaries stayed mostly flat, as did the reduced readmission rates for patients who follow their home health orders compared to those who don’t.

Adherent patients continue to be more than 50% less likely to be readmitted to the hospital compared non-adhering patients, a statistic that’s remained consistent since Excel Health began reporting the measure in 2017.

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