Similarly to other post-acute sub-sectors, the home health industry maintains strong tailwinds from the aging demographic trend in the United States. Private equity investors and publicly traded operators alike are busy acquiring tuck-in home healthcare acquisitions to achieve scale. The reimbursement environment continues to see changes as CMS implemented the Patient-Driven Grouping Model and more recently finalized the new Home Health Value-Based Purchasing Model.

Home healthcare encompasses a wide range of services that are administered part-time or intermittently in a person’s home. The goal of these services is to treat an illness or injury, reduce hospital readmissions, and improve patient recovery time through personalized care in the comfort of the patient’s home. To qualify for coverage of home healthcare services under Medicare, beneficiaries must be:

  • Homebound (i.e. unable to leave the house without a considerable taxing effort)
  • Require intermittent skilled nursing, physical therapy, or speech therapy services
  • Receive treatment under a plan of care established and reviewed by a qualified physician

In contrast to coverage for skilled nursing facility services or certain other post-acute care settings, Medicare does not require a preceding hospital stay for the patient to qualify for home healthcare services.