“PDGM [Patient Driven Groupings Model] is going to be big,” says Managing Director Bradley Smith of Vertess, a Texas-based healthcare focused M&A advisory firm.
PDGM is a new case-mix classification model used to structure healthcare payment categories and reimbursement thresholds. Come January 1, 2020, there will be a change in the unit of home health payment from a 60-day period to a 30-day period, forcing smaller providers to make substantial adjustments to their operating models.
“It will be similar to what happened in home health in 2000, and it will cause a massive consolidation. Similar to competitive bids that the DME [Durable Medical Equipment] market went through in 2009 and 2010, we are going to see a consolidation of a significant portion of the marketplace, creating opportunity for existing players and generating more PE interest. PDGM is a disruptive opportunity for them to execute a rollup strategy and capture a substantial part of the market,” says Smith.