Frost & Sullivan's expert analysts thoroughly examine the following markets: respiratory therapies, infusion therapies, home medical equipment, and home nursing services.
The following technologies are covered in this research:
- Respiratory Therapy (RT): This includes equipment and services to treat breathing disorders such as chronic obstructive pulmonary disease (COPD) and sleep apnea. Devices in this segment include oxygen-therapy products, nebulizers, sleep apnea therapy equipment and ventilators.
- Infusion Therapy: Home infusion therapy involves the administration of drugs into a patient's bloodstream. Infusion services are rendered to patients with chronic conditions that require infusion care services (such as pain management, parenteral nutrition, and diabetic therapy) and acute conditions requiring short-term infusion (such as antibiotic therapy, post-operative pain management, chemotherapy, and obstetrical therapy). Pumps that are most commonly used at home include insulin, ambulatory, syringe, enteral and large volume infusion pumps.
- Home Medical Equipment: The home medical equipment segment within home healthcare includes the provision of the following equipment to patients at home: mobility aids, rehabilitation equipment and specialty beds and support systems.
- Home Nursing Services: Home nursing services include both skilled and unskilled services. Services rendered to patients at home include skilled nursing care, therapy services (physical, speech and occupational therapy), medical social services, and home health aides.
Reimbursement Issues Place Pressure on Providers' Bottom Lines
High operational costs coupled with continuous reimbursement cuts have created a challenging situation for North American home healthcare providers as they struggle to cope with falling profit margins, which are among the lowest in the healthcare industry. The introduction of the Balanced Budget Act in 1997 brought about major changes in the reimbursement scenario as it advocated the use of a prospective payment system rather than the previous cost-based system. Under the previous system, Medicare home health agencies were reimbursed according to per-visit costs with an upper limit on costs but unlimited visits, and this boosted home healthcare expenditure considerably till 1997. However, the interim payment system followed from 1998-2000 until the BBA-mandated system came into effect caused a significant decline in expenditure. The prospective payment system was finally implemented in 2000, and while many believe it will promote greater efficiency, there is no denying that home healthcare providers' bottom lines have been affected.
"Against such a backdrop, cost efficiency has become the name of the game," observes the analyst of this research service. "Payor mix diversification, geographic expansion and economies of scale are some of the benefits that home healthcare providers could take advantage of." In a fragmented market comprising more than 8,000 providers, consolidation increasingly seems to be the way forward as it helps reduce costs by achieving economies of scale. The opportunity to consolidate a fragmented market is potentially an exciting one for private equity participants.
With healthcare costs constantly increasing, the emphasis on delivering cost-effective care is stronger than ever before. Home healthcare is ideally suited to address such concerns, as it enables substantial cost savings compared to institutionalized care. This can be as much as 25.0 to 60.0 percent more, depending on the nature of the disease under treatment and the level of care provided. For some conditions such as low birth weight, homecare can offer savings of up to 99.0 percent. Furthermore, customized care helps keep costs minimal by doing away with extra hospital services that a particular individual may not really need.