Home Health Agencies See PDGM as Major Growth Opportunity

A joint survey from Dallas-based Axxess — a home health technology company — and advisory firm BKD reiterated that the Patient-Driven Groupings Model (PDGM) and staffing are the dominant contemporary concerns among home health agencies.

Released earlier this week, the 2020 Industry Trends Report collected responses from employees in many positions at both large and small home health players in late 2019. Unsurprisingly, the respondents largely agreed that PDGM would affect their organizations in the coming years.

At least 55% of the survey participants felt “somewhat concerned” about their organization’s viability in 2020, while 15% felt “very concerned” and 6% felt “extremely concerned.” The data reflects the anxiety among industry members about PDGM and other regulatory changes.


Generally, employees are less concerned at bigger agencies about PDGM’s impact, the Axxess and BKD survey found. One reason why: Larger agencies may have been able to make more pre-PDGM investments into systems and infrastructure before the overhaul went live on Jan. 1.

No one truly knows yet what the full effect of PDGM will be, but it’s clear some in the industry are more bullish than others. There weren’t many surprises in the results, but that was one clear take away from the survey, Tammy Ross, senior vice president of professional services at Axxess, told Home Health Care News.

“When the survey was done at the end of last year, the transition to PDGM and its potential impact was very much on everyone’s mind. And staffing continues to be a major challenge for the industry, so in that sense the survey didn’t reveal a major surprise,” Ross said. “Interestingly, while many agencies recognize dealing with PDGM as a major challenge, a significant amount also recognize it is among the best opportunities to grow business this year.”


Many home health insiders have echoed similar sentiments to HHCN in the past, pointing out that times of payment reform and general change are often extremely active from an M&A perspective.

Additionally, since the turnover of a new year and the official implementation of PDGM, Axxess has noticed patterns in the type of inquiries its gotten from its clients.

“We’re getting questions from clients related to managing the transition to PDGM, [and those] are primarily related to billing and cash flow,” Ross said. “The vast majority of our clients are finding it a pretty smooth transition, but to some extent it will now depend on how CMS is able to process the additional claims.”

So, even though a great deal of the survey respondents were worried at the time, their concerns over their agency’s viability could have since subsided.

Larger agencies also see risk-based population health management as having the potential to make a big impact in the near future. Only 10% of the overall polling population said they thought it would make the biggest impact on their organization in the coming years, but that number spikes to 20% within big agencies.

Although 43% said that regulatory changes like PDGM were the biggest challenge heading into the new year, a sizable 29% were most concerned about staffing for their organization. The next highest percentage behind those two was 8%, a tie between “maintaining relationships with referral sources” and “managing costs.”

According to the survey, most home health employees felt that “patient and client experience” was the most satisfactory area in their organization and that the “financial” area was the least satisfactory. Respondents were also more likely to be satisfied with leadership if they worked for a smaller organization.

Leadership will be important to navigate industry challenges and ease the anxieties that have surfaced because of them.

“Given the timing of the survey being at the end of last year, it’s not surprising that a majority expressed at least some concern in the face of the unknown related to the transition to PDGM,” Ross said. “We’ll be keeping an eye on how things develop to make sure our clients get what they need.”

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