Want to make creations as awesome as this one?

Transcript

Tailwinds

Headwinds

Proposed Services

SNF Market Size ($180 B) & Trends

$<$1B $$$1-$5B $$$$5B+

45

1.Pwc Strategy& Analysis 2. CMS 3. HHS 4. The Kaiser Family Foundation 5. CliftonLarsonAllen

Opportunity sizing assumptions:

  • SNF annual penalties paid
  • QIO-QIN SOW funding
  • SNF quality management market size

Existing competitors

  • Provide technical expertise around quality improvement agnostic of facility type or region
  • Support reduction and prevention of federal and state penalties
  • Enhance real-time visibility in occupancy of beds to optimize capacity and labor needed
  • Optimize workforce through learning and development to improve quality care delivery
  • Reduce administrative burden to allow clinical staff to work at the top of their license

Market Overview

  • ~14K CMS-certified facilities across the US
  • 36% of facilities are 1-2 star rated
  • SNFs incurred $185M in penalties in 2022
  • Nursing hourly wages increased 8.1%in 2021
  • SNF market size expected to increase by $235 B in 2030
  • 60% of facilities are owned by regional players (owners of 11-100 facilities)
  • Increasingly harsh penalties imposed for
  • non-compliance and quality deficiencies (avg penalty ~$18K)
  • SNF labor shortage and increasing reliance on contracted labor shortage puts pressure on administrative
  • overhead and quality of care
  • QIO-QIN regions are being consolidated into seven regions for the 13th SoW and contractors will be responsible for multiple providers, facility types, and communities
  • SNFs are facing extreme margin
  • pressures (e.g., facilities face negative
  • operating margins absent PHE funding),
  • likely limiting capital expenditure
  • SNF facility volume likely to remain flat
  • as interest in home health rises, but elderly population grows
  • Rise in MA enrollment (preventative, post-acute home-based care)suggests
  • SNF utilization may decrease

Opportunity size

  • Enhanced patient outcomes tracking and reporting
  • Workforce and capacity tracking and management
  • Program measurement & evaluation
  • Survey readiness
  • Tag remediation
  • Patient / facility educational content
  • Development of quality improvement programs

Services (illustrative; blue indicates proposed new service)

Quality Improvement & Management Optimization

Tailwinds

Headwinds

Home Health Market Size ($150 B) & Trends

  • Development of quality improvement programs
  • Regulatory tracking, reporting and analysis

Proposed Services

$<$1B $$$1-$5B $$$$5B+

46

$<$1B $$$1-$5B $$$$5B+

1.Pwc Strategy& Analysis 2. CMS 3. The Kaiser Family Foundation 4. CDC

Opportunity sizing assumptions:

  • Home health supply management market size
  • Home health quality management market size

Existing competitors

capacity to effectively and efficiently increase volume of patients served ●Reduce administrative burden to allow clinical staff to work at the top

  • Monitor and evaluate the changing regulatory environment to help providers stay ahead of unfavorable reimbursement models or new regulatory requirements
  • Support enhancement of provider capacity to effectively and efficiently increase the volume of patients served
  • Reduce administrative burden to allow clinical staff to work at the top of their license

Market Overview

  • Home health market size expected to increase to $250 B in 2030
  • $30B of supplies, equipment and drugs being moved from health systems to the home
  • ~11.5K home health agencies across the US, providing remote care delivery, compliance support, data, monitoring, and evaluation capabilities
  • ~70% of agencies are located in the Midwest/Southern regions
  • Spend on home health services increased by 21% over the last three years
  • Home health margins are healthy (avg. ~10% depending on size)
  • Home health capacity and resources limited (80% of agencies turned away referrals)
  • Evolving and rigorous regulatory and reporting requirements hinting at a need for robust expertise and improved data, reporting, and evaluation
  • Tremendous interest and investment in home health market by PE firms, providers, and payers (e.g., 15% increase in M&A year over year)
  • Reimbursement models are shifting from FFS rates to a per-visit model, suggesting a need to ensure services are provided efficiently
  • Providers have a renewed interest in supply chain management as COVID highlighted hotspots
  • CMS finalized a 3.9% reduction in 30-day payment rates to prevent overpayments

Opportunity size

  • Enhanced patient outcomes tracking and reporting
  • Workforce and capacity tracking and management
  • Program measurement & evaluation

Services (illustrative; blue indicates proposed new service)

Home Health Quality & Management Optimization

How will you contribute to growth here at Qsource?