美国安养院行业研究报告2009年8月

相似文件 换一批

是 否 +2 论坛币

k人 参与回答

经管之家送您一份

应届毕业生专属福利!

求职就业群

赵安豆老师微信：zhaoandou666

经管之家联合CDA

送您一个全额奖学金名额~ !

立即领取

感谢您参与论坛问题回答

经管之家送您两个论坛币！

+2 论坛币

2009 HOSPICE INDUSTRY OVERVIEW AND
UPDATE
Key Points
• With the Centers for Medicare and Medicaid Services (CMS) releasing its final rule on
hospice reimbursement at the end of July, we thought it would be a good time to provide
investors with a general overview and an update of the hospice industry. We now have some
clarity around hospice reimbursement rates for the next 12 months and felt investors could
use a primer that clarifies some of the more complicated dynamics of the industry. Beyond
the overview in this report, we also provide a view of the competitive landscape, breakdowns
of beneficiaries, market size and penetration, hospice reimbursement, and MedPAC’s
proposal for hospice reimbursement reform. Key points we would like to highlight follow.
• Hospice reimbursement environment is showing some resiliency. CMS’ final rule
provided a net increase of 1.4% in Medicare reimbursement rates, which was 250 bps better
than the 1.1% cut under its April proposal. While the market basket update of 2.1%
remained unchanged, the 250 bps upside was entirely attributed to the extension of the
budget neutrality adjustment factor (BNAF) phase-out over seven years compared to the
previously more aggressive two-year period. The slower phase-out of the BNAF payments is
a net positive for the industry and gives observers a little better insight into how CMS is
viewing the hospice market. With industry margins running at an already slim 3%–4%,
most hospice operators appeared to view the initial proposed rule as a sharp cut that many
would struggle to absorb. The industry lobbied for more reasonable pricing and received
just that in the final rule. As a reminder, the hospice rate year starts on October 1, so Q4’09
begins the 2010 rate year that will conclude by September 30, 2010.
• Medicare cap becoming more manageable. While investors must take into account
the inherent risk that comes with operating under the Medicare cap, what had once been a
fearful dynamic to the industry has started to become a more manageable problem. In
particular, we point to the anecdotal improvements that larger, publicly traded companies
such as Odyssey Healthcare have experienced in recent quarters with managing through
the cap. The one caveat for investors is that Q4 does tend to have higher levels of Medicare
cap, and we do not expect 2009 to be any different.
• Positive signs out of the legislative environment. The hospice industry has recently
garnered greater support in Washington, where various proposals are currently being
discussed, most of which view the industry as an effective solution to the many issues raised
during end-of-life care. While the brouhaha around the controversial end-of-life provision
has subsided and it is unlikely to be included in the final version of healthcare reform
legislation, we have seen some proposals that aim to continue to educate the public and
expand the hospice benefit beyond the current six-month life expectancy period. While it is
always possible for Congress to implement something as negative as a market basket freeze,
we do not expect that to occur for an industry that provides considerable cost savings
compared to the more costly alternatives.
• Industry outlook much improved. The overall hospice industry continues to expand
both in terms of the number of individuals serviced and the types of diseases covered, but
the more important aspects for investors are the industry’s ability to preserve
reimbursement and manage through the artificially imposed Medicare cap. From our
perspective, both of these key areas have seen improvement in recent years. While
reimbursement risk is a relative constant, quality operators have had a number of years to
gauge the difficulty of the Medicare cap environment and tweak their operating practices. In
addition, hospice has moved from once being a social stigma to a widely accepted alternative
for end-of-life care, driving continued and expanded use of these types of services. We are
beginning to see more coupling of home health operators with hospice programs, and we
expect to continue seeing consolidation of this highly fragmented industry with larger
entities having a decided advantage in managing the Medicare cap.

扫码加我 拉你入群

请注明：姓名-公司-职位

以便审核进群资格，未注明则拒绝

分享0 收藏0 回帖

关键词：行业研究报告 研究报告 行业研究 Improvements alternatives 美国 研究报告 行业 安养