Post-Acute Care Industry Outlook - Nashville
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Post-Acute Care Industry Outlook The Post-Acute Care (“PAC”) market will undergo significant transformation over the next five years and beyond as various demographic and industry trends develop. Some sectors of the PAC market have already seen significant investment activity (e.g. home health, hospice), but other relatively untapped sectors stand to benefit from the overall market trends and could represent attractive investment opportunities.
Post-Acute Care Industry Outlook Q1 2020
Key Demographic Trends
In 2018, approximately 16% of the U.S. population was 65 or older. This group is
projected to increase by 30% to more than 70 million people by 2030,
representing 20% of the U.S. population
U.S. Population, Ages 65 and Older
(in millions) 79.8 83.7
72.7 8.0
3.3 5.6
56.1 16.1 22.1 22.9
2.8
40.3 10.4
1.9 33.2 32.7
9.4 34.0
24.8
16.6
18.1 20.1 18.1 20.1
12.4
2010 2020 2030 2040 2050
Age 65 - 69 Age 70 - 79 Age 80 - 89 Age 90+ Total
The increase in the number of Who Receives Long-Term Care?
older Americans will have a Residential Care Community 93.4%
6.6%
dramatic impact on the amount Nursing Home 83.5%
16.5%
of long-term care needed. The
Hospice 94.5%
vast majority of post-acute, long- 5.5%
Home Health Agency 81.9%
term care services are provided 18.1%
to the 65-and-older age group Adult Day Services Center 62.6%
37.4%
Age 65 and Over Under Age 65
~43% Lifetime healthcare costs incurred after age 65 by the average American
Sources: PRB, U.S. Census Bureau, Kaiser Family Foundation, MEPS, and AHCA
2
Post-Acute Care Industry Outlook Q1 2020
“Boomers vs. Beds”
By 2040, the aging Baby Boomer SNF Patient Volume Projections
3,000,000
generation is projected to fuel an
increase of more than 32% in 2,500,000
Skilled Nursing Facility (“SNF”)
2,000,000
patient volume
▪ Most of this growth will be realized in 1,500,000
the 75+ segment of the population
1,000,000
500,000
65-74 75-84 85+
Despite these trends, the number of Stagnation in Number of SNF’s
Post-Acute Care providers has
remained stagnant over the past
five years
▪ The average number of beds per
facility certified for
15,277
15,263
15,230
15,223
Medicare/Medicaid residents has
15,173
remained flat
▪ SNF’s, home health agencies,
inpatient rehab facilities and long-
2014 2015 2016 2017 2018
term care hospitals have all
experienced declines in the number
of providers
Sources: MedPAC and AHCA
3
Post-Acute Care Industry Outlook Q1 2020
Post-Acute Staffing Shortage
Nurses Geriatricians
An aging population, along with a lack of By 2030, 30,000 geriatricians will be
nursing school enrollment and faculty needed to care for the aging population.
members, will create a massive shortage The U.S. needs to train 1,500 geriatricians
of nurses in the next 10 years per year to catch up to demand
Insufficient Growth in Number of Nurses Demand for Geriatricians Already Outpaces Supply
1,550,222
6,000,000 40,000
needed
30,000
30,000
4,000,000 20,053
20,000
2,000,000 12,774
10,000
7,279
- -
2016 2021 2026 2017 2030
Actual (Expected) Needed Actual Needed
Unskilled Aides Behavioral Health Psychiatrists
The demand for home-health and personal 20% of adults aged 60 and over suffer
care aides is projected to grow 36% over from mental or neurological conditions
the next 10 years
Falling Number of Psychiatry Trainees in Geriatric
Shortage of Home-Health and Personal Care Aides Subspecialty
67
65
5,000,000 4,438,000
4,000,000 1,185,800 58 58
56
3,000,000 53
2,000,000
3,253,000
1,000,000
-
2018 2028 2012 2013 2014 2015 2016 2017
Actual Needed
Sources: United Health Foundation, U.S. Bureau of Labor Statistics, AARP Public Policy Institute, American
Psychiatric Association, SAMHSA, World Health Organization, American Association of Suicidology
4
Post-Acute Care Industry Outlook Q1 2020
Shift in Reimbursement Landscape
Changing payment structures: the transition to value-based care models is
underway and big changes are already being seen, specifically in post-acute
care. More changes are to be expected
Number of States with Value Based Care Reform Initiatives
47 48
40
33
16
4 6
3
2011 2012 2013 2014 2015 2016 2017 2018
Medicare Advantage Enrollment Increase
(in millions)
1.4 20.4
1.4
1.1 0.8
1.3
1.3
11.9
2011 2012 2013 2014 2015 2016 2017 2018
Change in Payment Models
Effective Date
Home Health Care January 1st, 2020 Patient-Driven Groupings Model (PDGM)
Skilled Nursing Facilities October 1st, 2019 Patient-Driven Payment Model (PDPM)
Medicare Initiative October 1st, 2018 Bundled Payments for Care Improvement (BPCI)
Sources: CDC, Kaiser Family Foundation, and eHealth
5
Post-Acute Care Industry Outlook Q1 2020
Telehealth
Post-acute providers are also reducing unnecessary hospital and doctor visits by
utilizing telehealth for either pre- or post-treatment services
▪ Studies show that 60 - 70% of all nursing home transfers to hospitals are unnecessary
▪ In 2016, U.S. healthcare providers saved almost $2,750 per patient when utilizing
telehealth in place of in-person treatment for post-discharge physical therapy
34.7% Annual growth in Revenue from 2014 to 2019 in the Telehealth Services industry
2019 Revenue in the Telehealth Services industry. Projected to grow at an
$2.4B annualized rate of 9.2% to $3.7 billion in 2024
Of industry executives in both acute and post-acute sectors indicated they were
83% likely to invest in Telehealth
Medicare and Medicaid reimbursement for Telehealth services varies state by
state and is currently still relatively limited:
Telehealth Description Medicare Coverage Medicaid
Service Coverage
Live Video Two-way interaction between a person Only for specific services Varies by state
(patient, caregiver, or provider) and a
provider using audiovisual
telecommunications technology
Store-and- Collecting clinical information and Prohibited, except for CMS Varies by state
sending it electronically to another site demonstration programs in
Forward for evaluation (Ex: medical documents, Alaska and Hawaii
demographic data)
Remote Use mobile medical device to collect Reimburses for certain kinds Varies by state
medical and other forms of health of services that are furnished
Patient data from individuals in one location remotely using
Monitoring and electronically transmit that communications technology
information securely to health care but are not considered
providers. Medicare “telehealth
services.”
Sources: CDC, Kaiser Family Foundation, and eHealth
6Post-Acute Care Industry Outlook Q1 2020
Impacts of Industry Trends & Issues
Trends
Increasing Clinician & Staff Reimbursement
Demand Shortages Changes
Issues
Productivity & Increased
Access to Care
Cost Pressures Uncertainty
Impacts
Risk Allocation Amongst
New Models of Care
Payer/Provider
Increased Technology Utilization Partnerships
Outsourcing
7Post-Acute Care Industry Outlook Q1 2020
New Models of Care
Possible Developments Example Companies
Multi-Sector Providers
Care Coordination Companies
Telehealth
Wellness
Retail Care Expansion
8Post-Acute Care Industry Outlook Q1 2020
Risk Allocation Amongst Payer/Provider
Possible Developments Example Companies
Payer/Provider Convergence
9Post-Acute Care Industry Outlook Q1 2020
Increased Technology Utilization
Possible Developments Example Companies
Outcomes Measurement &
Analytics
Patient Engagement
Risk & Value Based Payment
Technology
Remote Patient Monitoring
10Post-Acute Care Industry Outlook Q1 2020
Partnerships and Outsourcing
Possible Developments Example Companies
Industry Partnerships
Staffing Companies
11Post-Acute Care Industry Outlook Q1 2020
Select Avondale Transactions and Senior Team
Avondale Partners is an investment banking firm focused on the healthcare services and
healthcare technology sectors. We differentiate ourselves by achieving superior outcomes
for our clients through senior-level attention from bankers averaging more than 20 years of
experience. More information can be found at www.avondalepartnersllc.com.
Home Health Care of
East Tennessee,
Continue Care and
Debt Recapitalization affiliates
With Financing Provided By Have Been Acquired By Has Been Acquired By
A subsidiary of
Exclusive Financial Advisor to
Generations Behavioral Health, LLC Exclusive Financial Advisor to the Seller Buy-side Advisor to Baird Capital
A Majority Interest Has Been Acquired by Has Merged With Has Been Acquired by
A Portfolio Company Of
Exclusive Financial Advisor to Exclusive Financial Advisor to Exclusive Financial Advisor to
Beacon Specialized Living Services, Inc. Foothold Technology, Inc. Diagnostic Clinic Medical Group
Jonathan Morphett Philip Krebs Pat Shepherd Allison Brown
Managing Partner Managing Partner Managing Partner Managing Director
jmorphett@avondalepartnersllc.com pkrebs@avondalepartnersllc.com pshepherd@avondalepartnersllc.com abrown@avondalepartnersllc.com
Office: 615.467.3533 Office: 615.467.3482 Office: 615.467.3515 Mobile: 312.952.2078
Mobile: 615.594.5905 Mobile: 615.403.6530 Mobile: 615.430.2282
12You can also read
