Home Health Providers’ Referral Acceptance Rate Has Decreased by 15%

Patients being discharged from hospitals and into the post-acute space, including to home health providers, tend to be higher acuity and more complex than in the past.

The findings are part of a new report from CarePort, a WellSky company. The report examines data from over 1,000 hospitals and 130,000 post-acute care providers and focuses on how the COVID-19 emergency has impacted care delivery.

In general, patients discharged to home health providers have more complex conditions than in 2019. As a result, there’s been an 11% increase in average comorbidity score. Some common comorbidities are congestive heart failure, chronic obstructive pulmonary disease, hypertension, neurological disorders and diabetes.


“On average, higher acuity patients have a greater need for services post-discharge, adding increased complexity to getting that patient the care they need,” Dr. Lissy Hu, CEO and founder of CarePort, said in a press statement. “Giving providers the visibility and insight needed to provide the appropriate level of care post-discharge is critical to ensuring the best possible outcome.”

In recent years, some providers have positioned themselves to be able to take on higher acute and more complex patients.

Alivia Care — a provider of home health, hospice and palliative care services that operates across 32 counties in North Florida and Southeast Georgia — is one such company.


“We really wanted to be able to look at specific patient populations and what they needed that was different from the core components of service,” Susan Ponder-Stansel, CEO of Alivia Care, previously told Home Health Care News.

Other larger home health companies have done the same. LHC Group Inc. (Nasdaq: LHCG) has touted its own SNF-at-home capabilities, for instance. Amedisys Inc. (Nasdaq: AMED) acquired Contessa Health, which specifically deals with higher-acuity patients in the home.

Aside from higher acuity patients being discharged to home health, the report also found that staffing shortages have been disruptive to the referral process. Despite a 33% increase in referrals per patient to home health providers, there’s been a 15% decrease in acceptance.

“Ignited by increased patient demand for at-home recovery, as well as agency staffing challenges and capacity restraints, hospitals are struggling to locate home health agencies that are able to accept patients in a timely fashion,” CarePort wrote in the report.

On top of this, ensuring a timely start of care remains an issue even when home health placement is locked down. 

“Timeliness to start of care, a key home health measure, is critical to ensuring optimal patient outcomes,” the organization wrote. “In fact, CarePort data has found that the risk of hospital readmission rises by 3% each day after a patient is discharged and is not seen by a home health provider.”

Issues around provider referral acceptance, and start of care timeliness, also mean that patients often have to prolong their hospital stays.

In fact, the average hospital length of stay for patients being referred to home health has spiked by 8% since 2019.

“The industry must continue to solve for current challenges and usher in a new era of health care – one that is connected, collaborative, and focused on achieving the best possible outcomes,” Hu said. “Care coordination will play an important role by making providers aware of the availability and quality of services so patient needs can be met in a timely manner, without adding additional administrative burdens.”

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