How CMS’s New Payment Model Will Reshape M&A and the Practical Realities of Care
The Centers for Medicare & Medicaid Services (CMS) has just unveiled what may be one of the most consequential shifts in home health policy in over a decade. The ACCESS Model—a new tech-supported payment model focused on chronic disease management—signals a deep restructuring of how home health agencies will operate, deliver care, and position themselves for growth.
Two features stand out as true light-bulb moments:
Skilled home health can now support chronic disease management in certain scenarios, expanding the eligible patient pool well beyond traditional post-acute care.
CMS is formally embracing technology—remote monitoring, digital therapeutics, and flexible virtual/in-person care pathways—as a core part of skilled home health services.
These changes don’t simply adjust reimbursement—they fundamentally rewire the incentives, capabilities, and growth trajectories for providers.
And nowhere will this be felt more immediately than in M&A, where strategic differentiation, technology positioning, and chronic-care readiness will drive premiums and determine winners.
Acquire Care—a leader in strategic healthcare advisory, deal guidance, and operational optimization—sees this shift as a catalytic moment where strong, well-prepared home health operators will command meaningfully higher valuations. This change doesn't just bend the arc of deals; it reshapes the entire investment thesis for skilled home health agencies.
Let’s start where the industry is already buzzing: the M&A implications.
I. The M&A Landscape: A Perfect Storm of Opportunity and Competition
1. Chronic Care = Recurring Revenue = Higher Valuations
Under the traditional reimbursement structure, home health agencies were heavily tied to episodic, post-acute patterns—short-term spikes after hospitalization, followed by long gaps. That irregularity made valuations sensitive and difficult to predict.
Now, chronic disease management—diabetes, hypertension, musculoskeletal conditions, depression, and more—creates exactly what acquirers want:
Long-term, recurring, predictable revenue streams.
This is a seismic shift. Chronic conditions aren’t one-time events; they are lifelong. For home health operators who can serve this population, revenue becomes:
Stickier
More stable
More scalable
More defensible
In M&A terms, this means multiples go up. Agencies positioned for chronic-care delivery, supported by tech, will command a premium.
Acquire Care is already advising clients on how to reposition their service mix to maximize valuation, ensuring they’re at the front of the line when buyers start competing for chronic-care-ready providers.
2. Tech-Enabled Agencies Become the New Gold Standard
With CMS explicitly inviting technology-supported care—remote monitoring, asynchronous touchpoints, digital tools—the bar moves higher for what “high-performing home health” looks like.
Acquirers will begin looking for:
Remote patient monitoring workflows
Capacity to manage large chronic populations efficiently
Data-driven care processes
Virtual + in-person hybrid models
Population health capabilities
Agencies behind the curve on technology may become distressed assets. Agencies ahead of the curve become premium assets.
Acquire Care has already seen buyers shifting their criteria—favoring agencies with clear technology adoption roadmaps or existing RPM integration. This will accelerate quickly.
3. Consolidation Will Favor “Platform Builders”
The combination of chronic-care eligibility and tech-supported workflows creates scale economies that will reward larger, more sophisticated operators.
Expect the rise of:
Regional or national “platform” home health providers capable of managing tens of thousands of chronic patients
Private equity-backed roll-ups targeting tech-enabled home health as the anchor for value-based portfolios
Health-system alliances that leverage home health as the long-term chronic care arm
Smaller agencies may struggle to make the required tech investments—and will be motivated to sell rather than fall behind.
This is not a slow-burn shift. This is an immediate change to how the market sees opportunity.
Acquire Care is working with agencies on the buy side and sell side who recognize that timing matters—and early movers will extract far more enterprise value in the next 12–24 months.
II. Practical Care Implications: Changing What Home Health Does Every Day
While the M&A effects are substantial and already emerging, the practical care implications are equally transformative. Let’s break down the two most important:
1. Skilled Home Health for Chronic Conditions: A Break From Tradition
A Broader Clinical Scope
Traditionally, skilled home health centered on:
Post-surgical care
Wound care
Rehab after acute events
Homebound patients needing short-term support
Chronic disease management, however, was not considered part of the skilled benefit—it was the realm of physicians, care managers, outpatient clinics, or specialists.
But now CMS is explicitly allowing skilled home health to support chronic conditions in certain defined scenarios.
This means patients with:
Uncontrolled diabetes
Hypertension
Chronic pain or musculoskeletal disorders
Depression or behavioral health needs
Multiple co-morbidities requiring ongoing coordination
can receive certain skilled services at home, supported by a structured program.
This redefines home health as not just episodic care, but continuous care, fundamentally increasing utilization and long-term engagement.
Practical Changes Inside the Home
Agencies must now prepare for:
Longer-term patient relationships, not 30–60 day discharge windows
Chronic condition assessments and monitoring protocols
Medication adherence management
Preventive care instead of reactive care
Increased interdisciplinary coordination
More behavioral health integration
This is a shift from “treat the episode” to “manage the person.”
2. Technology Will Become a Mandatory Part of Care Delivery
CMS's ACCESS Model explicitly calls for technology use. This is not optional—it's foundational.
Remote Monitoring Becomes Routine
Patients can now be monitored at home via:
BP cuffs
Glucose devices
Wearables
Weight scales
Pain measurement tools
Mental health digital platforms
Remote data—and the interventions triggered by it—becomes part of skilled care.
Hybrid Care Pathways Become Standard
Instead of relying solely on in-person visits, agencies can now mix:
Virtual visits
Telehealth check-ins
Automated check-ins
Asynchronous messaging
Digital therapeutic engagement
Traditional in-home visits
This creates more frequent touchpoints without overloading nursing staff.
Data Becomes the Language of Care
To qualify for outcome-based reimbursement, agencies must show:
Blood pressure reductions
Improved glucose control
Decreased pain severity
Improved mental health metrics
Avoidance of ED visits or hospitalizations
Agencies will need dashboards, analytics, and structured documentation to participate meaningfully in this new ecosystem.
Home health becomes a technology-forward clinical environment, not just a set of in-home visits.
III. Why This Matters More Than Most Providers Realize
1. Chronic Conditions Are the Core of Medicare Spending
Up to 90% of Medicare spending is tied to chronic conditions. These are high-volume, long-term patients. They need ongoing engagement and support that home health is now allowed to help provide.
This unlocks a massive new addressable market.
2. The Change Supports Aging in Place
Older adults overwhelmingly prefer home-based care. Expanding home health into chronic care supports:
Independence
Safety
Early intervention
Long-term stability
It also aligns with broader national strategies around reducing institutional care.
3. Value-Based Care Finally Has a Home Health Arm
Primary care and specialty medicine have been moving toward value-based care for years. Home health, until now, hasn’t fully participated.
With outcome-based incentives tied to chronic disease metrics, home health becomes:
A partner in prevention
A manager of deterioration risk
A daily presence in chronic-care navigation
This is a structural breakthrough.
IV. Strategic Advice for Home Health Agencies
1. Build Chronic-Care Pathways Immediately
Agencies should define standardized protocols for:
Diabetes management
Hypertension monitoring
COPD or heart failure red-flag escalation
Chronic pain and mobility improvement
Mental or behavioral health screening
This is now the future core of home health.
2. Invest in Technology—Don’t Wait
RPM, telehealth, and digital engagement will become competitive differentiators. Early adopters will capture market share and valuation premiums. Waiting will create structural disadvantages.
3. Reposition Your Business for the New M&A Environment
Agencies that demonstrate:
Chronic care readiness
Tech-enabled efficiencies
Strong data reporting
Higher patient continuity
Predictable margins
will command superior valuations.
This is precisely why many agencies are partnering with advisory firms like Acquire Care—to ensure their business is positioned for maximum premium in a rapidly evolving market.
Conclusion: A Defining Moment for Home Health—and a Call to Action
The CMS ACCESS Model is not a minor update—it’s a redefinition of what home health is and what it will become.
M&A will accelerate.
Chronic care will expand.
Technology will become non-negotiable.
Valuations will rise—for agencies that adapt.
Acquire Care is deeply engaged in preparing home health agencies for this transition—both to operationalize chronic-care models and to position themselves for premium valuations in the most meaningful M&A environment this industry has seen in a decade.
If you're a home health operator, owner, or investor, this is the moment to act—not in a year, not when CMS fully rolls out the model, but now.
Acquire Care stands ready to help you evaluate your readiness, redesign your care pathways, modernize your technology engagement, and position your agency for a premium in this new market.
Because this time, the change isn’t incremental.
This time, the change is structural.
And the window to get ahead is already open.
