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Changes in the Medicare Home Health Care Market

The Impact of Reimbursement Policy

Bibliographic Data

ID9103041
AuthorsSunha Choi (0000-0002-0184-9933, Binghamton University, corresponding author), Joan K Davitt
Year2009
Volume47
Issue3
Pages302-309
Publication date2009-03-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31818afbf9
PMID19194328
OpenAlexW2102783710
LanguageEN
Citations received2
References cited11

BACKGROUND: The Balanced Budget Act of 1997 introduced 2 new reimbursement structures, the Interim Payment System (IPS, 1997-2000) and the Prospective Payment System (PPS, begun October 2000) for Medicare home health agencies (HHAs) under the fee-for-service program. OBJECTIVE: This article describes and compares the impact of these changes on the Medicare home health market from a period before the BBA through the IPS and PPS in relation to agency characteristics. RESEARCH DESIGN: A secondary analysis of 1996, 1999, and 2002 Provider of Services data was conducted on all Medicare-certified HHAs. Frequencies and rates of change were calculated by agency characteristics to describe changes in the number of active agencies through those years. Logistic regression models were used to compare factors associated with market exits under different payment systems. RESULTS: The results indicate dramatic but disproportional changes in response to the IPS and the PPS among Medicare home health care agencies. Agency closures were greater and market entries fewer during the IPS, but more branch offices/subunits were closed during the PPS. Proprietary and freestanding agencies experienced greater volatility throughout, with the greatest number of closures seen in Region VI (Dallas). CONCLUSIONS: These results demonstrate the direct impact of policy changes on the home health care market and highlight the need to evaluate policy changes to understand both intended and unintended impacts on health markets. Future research should analyze the effect of these policy changes on other healthcare providers and systems and their impact on health outcomes for Medicare beneficiaries

Actuarial science · Business · Economic growth · Economics · Family medicine · Health care · Home health · MEDLINE · Political science · Geriatric Care and Nursing Homes · Global Health Care Issues · Healthcare Policy and Management · Medicine · Nursing

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Citations per year0.33
Citation span2020 - 2021 (2)
Highly citedNo

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