New Data Confirms More Patients Are Being Discharged to Home Health Agencies

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Patients discharged from hospitals are increasingly headed to home health agencies, a new analysis from ATI Advisory shows.

In May 2019, of the 801,464 patients discharged from short-term acute care hospitals (STACHs), 11% were sent to home health agencies. In May 2020, of the 558,296 patients discharged from STACHs, 19% went to home health agencies.

The analysis took into account Medicare fee-for-service claims data incurred from January through May, then paid through June.

On a basic level, these latest figures confirm the role home health agencies have played during the COVID-19 pandemic. They also support comments made by the several home health executives who have said their referral partners have turned to in-home care more readily than in the past.

Yet it’s unclear if the shift toward home health is here to stay, according to Anne Tumlinson, founder and CEO of ATI Advisory.

“We don’t know yet how permanent this disruption in post-acute care discharge patterns will be,” Tumlinson told Home Health Care News in an email. “If it holds, it will be positive for home health when the pandemic eases and if hospital volumes return – even when the waivers go away. In other words, if they hold onto the size of their slice of the pie and the pie increases, that’s good for the industry overall.”

Of the 104,886 patients diagnosed with COVID-19 that were discharged from STACHs from January to May of 2020, 8% went to home health agencies. In comparison, 25% went to skilled nursing facilities (SNFs), with another 29% discharged directly home without services.

Of the 3.21 million STACH discharges to take place from January through May 2020, 17% were for home health care, according to the ATI Advisory analysis.

“I would say that we are very lucky that the Patient-Driven Payment Model (PDPM) and Patient-Driven Groupings Model (PDGM) were in place because they allow for the appropriate reimbursement for what is probably a more complex patient population overall,” Tumlinson said.

The ATI Advisory analysis is also noteworthy from a SNF-diversion perspective.

In May 2019, for instance, SNFs received 19% of all patients. But in May 2020, SNFs only received 15%.

Agencies have been bullish on SNF-to-home diversion since the outset of the COVID-19 pandemic. Still, SNFs are hopeful that the SNF-to-home trend will subside once the pandemic eases.

While these trends look good for home health agencies, they’re not necessarily indicative of the status quo moving forward.

Additionally, the analysis only takes into account Part A reimbursement for home health agencies — community-admits are not considered in the data.

“We would caveat this analysis by saying that it’s the claims data from just the first three months of the pandemic,” Elizabeth Burke, an analyst at ATI Advisory, told HHCN in an email. “We’ll have a better understanding of what this all means as we examine the data over time – when the next few quarters come in.”

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