Pre-Claim Reviews Present Challenges & Opportunities

Stoneridge Partners | Pre-claim reviews present challenges & opportunities, according to Don Cummins, founder of Stoneridge Partners.

“The changes during the early 2000s are not unlike those the industry is currently experiencing; only now, instead of one big cut, it is more like death by a thousand cuts… pre-claim reviews, value based purchasing, star ratings, managed care, etc. All present both a challenge and an opportunity,” explains Don, who has more than two decades in the healthcare mergers and acquisitions industry.

Across the home health care landscape, there are roughly 13,000 certified Medicare home care agencies. Among them, about 6,000 are doing less than $1 million in annual Medicare revenue and 10,000 are doing less than $2 million. The challenges are obvious. The opportunities are there for companies already in and those looking to enter this marketplace.

Cummins concludes, “The market for home care will continue to grow as our nation continues its commitment to the health and well-being of the elderly.”

Ultimately, the industry has strong growth potential; and, SStoneridge Partners | Pre-claim reviews present challenges & opportunitiestoneridge Partners will continue to serve in a deal-making capacity with its longtime knowledge and expertise. From public companies to private ones, small to large, our deal-making team has a pulse on the market which it brings to each transaction.


For more information on pre-claim review, visit the Centers for Medicare and Medicare Services (CMS) at www.cms.gov. CMS is part of the Department of Health and Human Services (HHS). Watch a short video to get to know about CMS and its work, mission, and vision. Programs administered by CMS include: Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace.