Home Healthcare Services

Industry Profile Report

Dive Deep into the industry with a 25+ page industry report (pdf format) including the following chapters

Industry Overview Industry Structure, How Firms Opertate, Industry Trends, Credit Underwriting & Risks, and Industry Forecast.

Call Preparation Quarterly Insight, Call Prep Questions, Industry Terms, and Weblinks.

Financial Insights Working Capital, Capital Financing, Business Valuation, and Financial Benchmarks.

Industry Profile Excerpts

Industry Overview

The 24,400 home healthcare service firms in the US offer skilled nursing and other types of health-related services in the home. Major service categories include traditional home healthcare services (with or without rehabilitative services), home hospice care, home nursing care, homemaker and personal care, home infusion therapy, and the rental or lease of goods and/or equipment. Companies may specialize in a particular service, such as respiratory therapy or hospice care.

Dependence On Third Party Payers

Home healthcare services providers are dependent on third party payers, including Medicare, Medicaid, private insurance companies, and managed care organizations, as sources of revenue.

Risk Of Malpractice

The inherent risk in providing healthcare outside a traditional setting exposes companies to the risk of malpractice.

Industry size & Structure

The average home healthcare services provider operates out of a single location, employs about 61 workers, and generates $4 million in annual revenue.

    • The home healthcare services industry consists of about 24,400 firms that employ 1.5 million workers and generate $100 billion annually.
    • The industry is fragmented; the top 50 firms account for 33% of industry sales.
    • Large companies include Apria Healthcare, Lincare Holdings, Amedisys, and Kindred at Home (formerly Gentiva Health Services).
                                    Industry Forecast
                                    Home Healthcare Services Industry Growth
                                    Source: Vertical IQ and Inforum

                                    Coronavirus Update

                                    May 4, 2022 - Telehealth Usage Soared During First Year Of Pandemic
                                    • Telehealth usage increased more than 7,000% year over year in 2020, according to nonprofit Fair Health’s fifth annual healthcare indicators report released in March. Many consumers and providers who have embraced online care are lobbying legislators to expand telehealth access once the national health emergency ends, according to the report.
                                    • Some healthcare industry experts say that an expected wind down of pandemic-related emergency measures could create major disruptions for a US health care system made more generous, flexible, and up-to-date technologically. Winding down those policies could begin as early as the summer. That could force an estimated 15 million Medicaid recipients to find new sources of coverage, require congressional action to preserve broad telehealth access for Medicare enrollees, and scramble special COVID-19 rules and payment policies for hospitals, doctors, and insurers. There are also questions about how emergency use approvals for COVID-19 treatments will be handled. The Public Health Emergency declaration that enabled the emergency measures is set to end on April 16, but many experts expect the Biden administration to extend it through mid-July.
                                    • The US Supreme Court allowed a vaccine mandate to stand for medical facilities that take Medicare or Medicaid payments. "We agree with the Government that the [Health and Human Services] Secretary's rule falls within the authorities that Congress has conferred upon him," said the majority, writing that the rule "fits neatly within the language of the statute. After all, ensuring that providers take steps to avoid transmitting a dangerous virus to their patients is consistent with the fundamental principle of the medical profession: first, do no harm."
                                    • Healthcare facilities with 10 or more employees must conduct a hazard assessment and have a written plan to reduce coronavirus spread, according to new, temporary standards issued by the federal Occupational Safety and Health Administration. Employers must also supply some employees with N95 respirators or other personal protective equipment. The standard also requires covered employers to provide workers with paid time off to get vaccinated and to recover from any side effects of the vaccination. Covered employees who have the virus or who may be contagious must work remotely or otherwise be separated from other workers if possible or be given paid time off up to $1,400 per week. For most businesses with fewer than 500 employees, paid leave may be reimbursed through tax credits in the American Rescue Plan.
                                    • The Centers for Medicare and Medicaid Services (CMS) has begun recoupment of accelerated and advance Medicare payments from providers, including home healthcare services, that borrowed the emergency funds one year ago to battle COVID-19. An accelerated or advance payment is a payment from CMS that is intended to provide necessary funds when there is a disruption in claims submission and/or claims processing. CMS can also offer these payments in circumstances such as national emergencies or natural disasters in order to accelerate cash flow to the impacted health care providers and suppliers. Recipients were originally supposed to start paying back pandemic-related payments in August 2020, but CMS extended the repayment period until one year after the funds were loaned. CMS will withhold 25% of Medicare payments for 11 months or until the amount has been paid back. If the advanced payments have not been received by that point, CMS will withhold 50% of Medicare payments for up to six months and then issue a demand letter for the balance.
                                    • The home healthcare industry may fare better than its post-acute care counterparts in repaying advance payments, according to Sherill Mason, principal at Mason Advisors, which provides strategic planning and operations analysis to healthcare providers. “The sector is significantly healthier financially than their colleagues in the skilled nursing industry, where census has not rebounded,” Mason has said.
                                    • The federal Equal Employment Opportunity Commission said that employees may be barred from the workplace if they refuse the COVID-19 vaccine. "Requiring a vaccine is a health and safety work rule, and employers can do that," said Dorit Reiss, a professor at the University of California Hastings College of Law. There are, however, some exceptions to a blanket requirement. A collective bargaining agreement may require negotiating with a union before mandating a vaccine. The Americans with Disabilities Act allows workers who don't want to be vaccinated for medical reasons to request an exemption.
                                    • Employment in the home healthcare industry increased 2.6% year over year in March, according to the US Bureau of Labor Statistics. Home healthcare services saw a surge in demand in the wake of COVID-19 due to concerns about outpatient visits and rising infections and deaths in nursing homes.
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