Home Health Agencies’ Ownership Type, Chain Affiliation and Financial Performance

Home health agencies (HHAs) continue to be a very relevant provider within the U.S. healthcare system. The aim of this cross-sectional observational study was to examine the possible correlation of ownership type and chain status on Medicare Certified HHA’s financial performance in the 2018 to 2019 fiscal years. Observational, cross-sectional study. This study included 20,211 observations from approximately 10,195 free-standing home health agencies that participated in Medicare reimbursement for the fiscal years 2018 to 2019. Ordinary least squares regression. Using ordinary least squares regression to analyze data from Medicare care reports, for 2018 to 2019, this study found that for-profit ownership status and chain affiliation correlated more with positive operating incomes. We found 66% of for-profit chain HHAs earned positive operating incomes. This is compared with 61% of for-profit independent HHAs. Nonprofits experienced a similar result with regards to chain status, as 41% of chain affiliated non-profit HHA earned a positive operating income compared to 27% of independent non-profit HHAs. For-profit chain affiliated HHAs experienced superior financial performance using operating income as a measurement of financial performance relative to other HHAs. Given their stronger financial performance, potential shifts toward chain affiliated HHA organizations seem plausible. Proposed MEDPAC reimbursement decreases may be worth reconsidering as they may further dwindle the financial viability of non-profit HHAs.