With PDGM Looming, Home Health Providers Down on Therapy Services

To better position themselves for changing demographics and other industry headwinds, a sizable chunk of home health providers plan to further diversify their specialty services within the next two years. That’s mostly true for everything apart from therapy-related services, which virtually no providers plan on expanding anytime soon. 

That’s at least according to a new study from Definitive Healthcare, a Framingham, Massachusetts-based provider of health care data and analytics. The organization released its 2019 Home Health Agency Study on Tuesday.

Overall, the study included insights from 159 home health agencies, with the group consisting of roughly 70% agency-level providers and 30% corporation-type businesses. Of the 159 respondents, 73% said they generally planned to either expand or launch specialized care offerings.


“Areas of specialized care are expanding pretty quickly,” Matt Valley, a senior health care analyst at Definitive Healthcare, told Home Health Care News. “[Home health agencies] have seemingly begun tailoring their care to specific disease states or conditions. And I think it’s very telling that over the next two years, nearly three-quarters of responding organizations were planning to either expand to additional disease states and conditions or begin offering specialized care as a specific service line at their organization.”

Among home health agency respondents, the average number of service offerings was 3.6, according to the Definitive Healthcare study. More than 85% of home health agencies said they currently offer therapy services, making it, by far, the most common offering.

However, exactly zero respondents said they planned to expand their therapy offerings within the next two years. That’s not too surprising, as the Patient-Driven Groupings Model (PDGM) shifts home health Medicare reimbursement more toward nursing services and changes how therapy is paid for.


While not a single home health provider that participated in the Definitive Healthcare study said they planned on launching or expanding new therapy offerings, nearly 28% said they had ambitions on establishing new telehealth services. Meanwhile, more than 6% said they planned on launching or expanding transportation services, with a slightly smaller share planning to launch or expand into hospice.

In addition to providing insights into care trends, the Definitive Healthcare study also shed light on home health industry challenges.

Because the senior citizen population is projected to rapidly increase, employment within the home health industry is also expected to rise 36% by 2028, which comes out to over 1 million jobs. That’s not likely to be a seamless transition, considering that over 60% of Definitive Healthcare survey respondents said “finding and hiring qualified staff” is one of the greatest challenges facing their organizations.

The next highest concern was profitability, which 42.1% of organizations chose as a greatest challenge.

Of the agencies that were concerned about finding and hiring qualified staff, 25% were planning to move into telehealth over the next two years. The most popular telehealth services currently being used — and also being planned for future use — were remote patient monitoring, either into the home or via consumer devices (patient-generated patient data). 

Wound care, cardiac disease states and COPD are the top three conditions currently served by the home health respondents in the Definitive Healthcare study.

“I think the primary driver diving into the research was knowing that the space was expected to grow in the near-term future,” Valley said. “And we saw that the U.S. Bureau of Labor Statistics was forecasting considerable growth in [home health agency] employment over the next 10 years … We really decided to take an approach of kind of seeing if [agency] leadership and their viewpoints on their environment, if their perspectives end up lining up with what we’ve been reading and seeing in the news.”

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