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The post-acute care industry: Five trends worth watching


In its annual report, Trella Health outlined the opportunities and hurdles ahead for home health, skilled nursing and hospices.

The post-acute care industry has potential for growth in the coming years, but there are some formidable challenges.

Trella Health recently published its 2021 Post-Acute Trend Industry report. Trella Health, based in Atlanta, provides data analysis for home health agencies, skilled nursing facilities and hospice providers.

In 2021, inpatient discharge instructions to post-acute care agencies bounced back to levels before the COVID-19 pandemic, the report said. From the fourth quarter of 2020 to the third quarter of 2021, post-acute care instructions rose to 52.2%, up from 51.1%.

Post-acute care agencies need to understand the market forces to seize opportunities, the report stated.

Here are five noteworthy trends in the post-acute care industry, according to the report.

1. Home sweet home

Patients increasingly are opting to recover from a hospital stay at home, and the Trella Health report shows more evidence of the trend.

Post-acute care instructions rose to 24.1% between the fourth quarter of 2020 and the third quarter of 2021, an uptick of 2.5 percentage points.

On the downside, home health agencies continue to face an “unprecedented labor shortage,” the report stated. Home health admissions hovered around 850,000 per quarter in 2021, which is below pre-pandemic levels. In 2019, admissions topped 900,000 per quarter.

If home health agencies can address their staffing woes, they can take advantage of patient preferences to recover at home.

2. Struggles with skilled nursing

Skilled nursing facilities have faced serious difficulties during the pandemic. Nursing homes have been viewed as hotbeds of COVID-19 transmission, the report notes. COVID-19 deaths at nursing homes have drawn the attention of President Biden and lawmakers.

Discharges to skilled nursing facilities are dropping, Trella Health noted. Between the fourth quarter of 2020 and the third quarter of 2021, discharges to nursing homes fell to 18.6%, a drop of 2.4 percentage points.

Skilled nursing facilities have struggled to hire and retain workers for years, a problem that has accelerated in the pandemic.

“Skilled nursing facilities must work to rebuild their reputation,” the report stated.

3. Hope for hospices

Hospice admissions have grown steadily, and the report sees potential for substantial growth in this sector of the post-acute field.

Even with the COVID-19 pandemic, year-over-year hospice admissions grew by an average of 4% over the last seven quarters. With an aging population, hospices are poised for significant growth over the next decade, the report states.

While hospices are facing labor challenges for their own, they may have opportunities to find workers in underserved markets. Regardless,

“Now is the time for hospice agencies to invest in staff retention and take advantage of a market on the precipice of a growth explosion,” the report stated.

4. Medicare Advantage accelerates

Post-acute care agencies need to market themselves to Medicare Advantage plans, Trella Health said. Medicare Advantage plans, which are run by private companies, are surging in popularity.

Medicare Advantage plans are likely to cover over 50% of Medicare-eligible beneficiaries nationwide by 2025, according to the report. Between December 2016 and February 2022, enrollment in MA plans rose by 65.1%.

“MA is not going away,” the report stated

Post-acute care agencies that use Medicare Advantage data will have an edge over competitors without that information..

5. Telehealth isn't going away

The growth of telehealth isn’t limited to younger, tech-savvy patients. Telehealth usage skyrocketed during the COVID-19 pandemic, and more seniors will continue to utilize telemedicine services, the report projected.

Telehealth usage among Medicare beneficiaries rose 63-fold in 2020. While telehealth usage has dipped from the peak in 2020 (when patients had no other option other than virtual visits), it remains far above pre-pandemic levels.

“This increase indicates a trend toward more acceptance of technology among Medicare-eligible patients – one that will likely continue to rise as more tech savvy patients become beneficiaries,” the report stated.

With telehealth, patients can avoid travel or exposing themselves to other patients with in-person visits.

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