Part B Home Health Episodes Increased Dramatically in 2020

The demographic profile of home health users continues to skew older, with the vast majority of individuals also having three or more chronic conditions. The setting users found themselves prior to starting home health services additionally continues to skew toward the broader community.

That’s according to the 2021 Home Health Chartbook, released earlier this month by the Alliance for Home Health Quality and Innovation in partnership with Avalere Health.

The most recently available data shows that one-quarter of home health users are 85 or older, with one-third of users between the ages of 75 and 84. Just 41% of the home health population is under the age of 74, according to the Chartbook.


In comparison, nearly 63% of the overall Medicare population is under the age of 74. Just 10% of the entire Medicare population is above 85.

Similar to the overall Medicare universe, home health users overwhelmingly live in urban areas.

When it comes to medical complexity, the most recently available data shows that home health users typically have more chronic conditions compared to the broader Medicare population.


Nearly 19% of home health users have three chronic conditions, with nearly 21% having four chronic conditions. Over 43% of home health users have at least five chronic conditions, according to the Chartbook.

In 2020, 57% of the Medicare beneficiaries admitted for a hospital stay were later discharged to the community. About 34% were discharged to a formal post-acute care setting.

Of those, 13% were discharged to the home health setting, with 16% discharged to skilled nursing facilities (SNFs). The percentage of Medicare beneficiaries referred to home health after a hospital stay actually decreased in 2020 compared to prior years, when between 19% and 20% of post-acute care discharges went to the home health setting.

That could partially be explained by a higher mortality rate in 2020 associated with the COVID-19 pandemic.

Nearly 59% of home health episodes began with users coming from the community — not an institutional setting. About 27% of episodes were preceded by a short-term acute care hospital stay, with nearly 9% preceded by a SNF stay.

Another interesting trend revealed within the 2021 Home Health Chartbook is a significant increase in the number of Medicare Part B home health episodes last year.

In 2021, there were 6.38 million Part B home health episodes, compared to 3.01 million Part A home health episodes. Previously, 2011 had the most Part B home health episodes, with 4.48 million.

The full findings from the 2021 Home Health Chartbook are available here.

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