{"id":113401,"date":"2020-03-04T13:31:14","date_gmt":"2020-03-04T17:31:14","guid":{"rendered":"https:\/\/livingstonepartners.com\/insights\/how-will-pdgm-affect-home-health-ma\/"},"modified":"2026-10-15T12:17:17","modified_gmt":"2026-10-15T16:17:17","slug":"how-will-pdgm-affect-home-health-ma","status":"publish","type":"insights","link":"https:\/\/livingstonepartners.com\/es\/insights\/how-will-pdgm-affect-home-health-ma\/","title":{"rendered":"\u00bfC\u00f3mo afectar\u00e1 el PDGM al M&amp;A en el sector de la atenci\u00f3n sanitaria domiciliaria?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/livingstonepartners.com\/es\/team-member\/jim-moskal\/\">Jim Moskal<\/a>, Socio y corresponsable del \u00e1rea de Healthcare de Livingstone, analiza el impacto del PDGM en el M&amp;A en&nbsp;<a href=\"https:\/\/www.homecaremag.com\/march-2020\/pdgm-mergers-acquisitions\">un art\u00edculo publicado originalmente en&nbsp;<em>HomeCare Magazine<\/em><\/a>.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">En octubre de 2018, los Centros de Servicios de Medicare y Medicaid (CMS) aprobaron definitivamente el <em>Patient Driven Groupings Model <\/em>(PDGM). La medida se consider\u00f3 la mayor reforma del sistema de reembolso de la atenci\u00f3n sanitaria domiciliaria (<em>home health<\/em>) en dos d\u00e9cadas. El modelo da m\u00e1s peso a las caracter\u00edsticas cl\u00ednicas del paciente, junto con otros datos, para eliminar los incentivos a prestar m\u00e1s servicios de terapia de los necesarios. Adem\u00e1s, reduce a la mitad la unidad de pago, que pasa del tradicional episodio de 60 d\u00edas a uno de 30.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Con este cambio, las agencias tienen que planificar, prestar, documentar y facturar la atenci\u00f3n con el doble de frecuencia. El modelo tambi\u00e9n preocupa por sus pol\u00e9micos ajustes de comportamiento (<em>behavioral adjustments<\/em>). Son recortes de tarifas que pretenden compensar la posibilidad de que las agencias cambien sus pr\u00e1cticas para maximizar los pagos con el PDGM. CMS propuso primero un ajuste que reduc\u00eda los pagos un 6,42%. Despu\u00e9s lo subi\u00f3 al 8,01% y, por \u00faltimo, lo rebaj\u00f3 al 4,36%, que es la cifra que se aprob\u00f3.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hist\u00f3ricamente, el impacto medio de estos ajustes en un solo a\u00f1o se ha situado entre el 2% y el 3%, muy lejos del ajuste m\u00e1ximo del 8,01 % que CMS defendi\u00f3 para el PDGM. Los proveedores argumentaron que esa cifra era poco realista y que pod\u00eda tener consecuencias catastr\u00f3ficas para las agencias peque\u00f1as y medianas.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Desde que se anunci\u00f3 el plan a finales de 2018, los expertos han advertido de escenarios muy negativos. Entre ellos, recortes de tarifas para todo el sector y estimaciones seg\u00fan las cuales hasta un 30% de las agencias de\u00a0<em>home health<\/em> podr\u00edan cerrar.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Como era de esperar, la actividad de fusiones y adquisiciones (M&amp;A) se fren\u00f3 en el segundo semestre de 2019. Proveedores y compradores esperaban a que el nuevo modelo de reembolso entrara en vigor el 1 de enero de 2020. En el tercer trimestre de 2019, el n\u00famero de operaciones en&nbsp;<em>home health<\/em>&nbsp;y cuidados paliativos (<em>hospice<\/em>) cay\u00f3 un 23 %, hasta 20 transacciones anunciadas p\u00fablicamente, frente a las 26 del segundo trimestre.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Si se compara con el tercer trimestre de 2018, cuando se anunciaron 25 adquisiciones, la actividad de M&amp;A en\u00a0<em>home health<\/em>\u00a0y\u00a0<em>hospice<\/em>\u00a0baj\u00f3 un 20%. Con el PDGM en el horizonte, en 2019 los compradores apostaron m\u00e1s por las compa\u00f1\u00edas de\u00a0<em>hospice<\/em>, porque ese sector ten\u00eda un entorno regulatorio relativamente estable.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">La operaci\u00f3n de\u00a0atenci\u00f3n sanitaria domiciliaria\u00a0m\u00e1s destacada de 2019 se cerr\u00f3 en mayo, cuando la firma de Private Equity Advent International adquiri\u00f3 AccentCare. En el segundo semestre del a\u00f1o no se complet\u00f3 ninguna transacci\u00f3n de tama\u00f1o relevante. Predominaron las operaciones peque\u00f1as y las adquisiciones complementarias (<em>tuck-in<\/em>).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">En muchos aspectos, 2019 prepar\u00f3 el terreno para los cambios de calado que se esperan en el sector en 2020. El nuevo entorno marcar\u00e1 c\u00f3mo operan los proveedores durante el pr\u00f3ximo a\u00f1o, y las agencias peque\u00f1as, medianas y grandes tendr\u00e1n sus propios retos y oportunidades. La consolidaci\u00f3n y la adaptaci\u00f3n marcar\u00e1n el ejercicio.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Livingstone Partners prev\u00e9 un primer trimestre de 2020 tranquilo en M&amp;A. A partir del segundo trimestre, espera que el n\u00famero de operaciones aumente y se mantenga as\u00ed el resto del a\u00f1o. Las agencias de&nbsp;<em>home health<\/em>&nbsp;que vean reducidos sus reembolsos con el PDGM buscar\u00e1n vender ante las dificultades para mantener su viabilidad financiera. Esto abrir\u00e1 oportunidades para que los operadores m\u00e1s s\u00f3lidos ganen cuota de mercado a buen precio. El volumen de transacciones subir\u00e1, pero es probable que los m\u00faltiplos de valoraci\u00f3n bajen.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">La atenci\u00f3n sanitaria domiciliaria\u00a0sigue consider\u00e1ndose un sector muy fragmentado y podr\u00eda consolidarse a niveles que no se han visto desde la implantaci\u00f3n del <em>Prospective Payment System<\/em> hace 20 a\u00f1os. A los compradores estrat\u00e9gicos que ampl\u00edan su cuota mediante adquisiciones se sumar\u00e1, probablemente, un Private Equity con una presencia a\u00fan mayor en el sector este a\u00f1o. Las firmas de Private Equity disponen de 1,5 billones de d\u00f3lares de capital sin invertir, m\u00e1s liquidez que nunca.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">En definitiva, el sector superar\u00e1 el PDGM, pero cuando pase la tormenta ser\u00e1 muy distinto, sobre todo en n\u00famero de agencias. Las agencias de propiedad privada que sobrevivan y prosperen tras el PDGM estar\u00e1n en una posici\u00f3n excelente para presentarse ante el Private Equity como oportunidad de plataforma.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>La reforma del sistema de reembolso de Medicare para la atenci\u00f3n domiciliaria anticipa una ola de consolidaci\u00f3n, con m\u00e1s operaciones, valoraciones a la baja y un papel creciente del Private Equity.<\/p>\n","protected":false},"author":3,"featured_media":113400,"template":"","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[2763,2749],"tags":[],"sector":[],"service":[],"class_list":["post-113401","insights","type-insights","status-publish","has-post-thumbnail","hentry","category-in-the-press","category-thought-leadership"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.5 (Yoast SEO v28.5) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>\u00bfC\u00f3mo afectar\u00e1 el PDGM al M&amp;A en el sector de la atenci\u00f3n sanitaria domiciliaria? 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