Exploring the impact of acquisition on quality of care among US home health agencies.

Background: Throughout the United States and Europe, the home health care industry is rapidly consolidating, with merger and acquisition (M&A) activity on the rise.Purpose: The consolidation of the industry raises questions about the impact that diminished competition may have on the quality of care being delivered.Research Design: This study utilizes a weighted, staggered difference-in-differences analysis.Study Sample: This study examines the impact of home health agency acquisition on quality of care among a sample of 10,184 home health agencies across the United States.Analysis: Utilizing publicly available data from the Outcome and Assessment Information Set (OASIS) and the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) from 2018 to 2022, this study investigates changes in clinical outcomes, organizational process measures, and patient experience.Results: The findings suggest there is a modest 1.07 percentage point improvement in process measures post-acquisition, but no significant changes in outcome or patient experience measures among the 169 agencies that were acquired during the study period.Conclusion: These findings suggest that, while integration has the potential to modestly improve home health process efficiency, there is very little benefit to patients.