ABSTRACT
This article describes the Medicare home health benefit and summarizes the growth and change in the use of the benefit and in the industry providing home health care. The article details the progress the Home Health Initiative has achieved in the key areas of quality assurance, administration and operations, and policy. It concludes with a discussion of future directions for reforming Medicare's home health benefit.
Subject(s)
Home Care Services/statistics & numerical data , Medicare Part B/statistics & numerical data , Aged , Capitation Fee , Centers for Medicare and Medicaid Services, U.S. , Diagnosis-Related Groups , Health Care Reform , Health Care Surveys , Health Expenditures/statistics & numerical data , Health Expenditures/trends , Health Policy , Home Care Services/economics , Home Care Services/standards , Humans , Medicare Part B/standards , Patient Advocacy , Patient Care Planning , Prospective Payment System , Quality Assurance, Health Care , United StatesSubject(s)
Health Services for the Aged/economics , Medicaid/economics , Medicare/economics , Patient Selection , Aged , Centers for Medicare and Medicaid Services, U.S. , Cost-Benefit Analysis , Eligibility Determination , Humans , Long-Term Care/economics , Reimbursement Mechanisms/economics , United StatesABSTRACT
Recently, the use of home health services by Medicare beneficiaries has been growing. From 1987 to 1992, the percentage of all enrollees receiving home health rose from 4.8 to 7.2 percent, while the average number of visits among users increased from 23 to 54. This article uses the 1992 Medicare Current Beneficiary Survey (MCBS) to profile home health users. In addition to providing descriptive information about who uses Medicare home health, Tobit models are estimated to determine the factors that predict home health utilization and reimbursement. Various policy options for redesigning the home health benefit are also discussed.
