Managed Care and Home Health Care: Partnerships that Work for Patients

Abstract

The evolution of managed care to its place of dominance in the health care delivery system forever changed the roles and responsibilities of health care providers, home health agencies included. Yet care delivery decision making often occurred with the context on an uneasy truce. Home health nurses were chaffing under a perceived loss of professional autonomy while health plans regarded the care-giving community as indifferent to their attempts to merge fiduciary and clinical responsibilities. By the mid-1990s, a group of plans and home health providers in Massachusetts decided it was time to talk, resulting in some not so surprising benefits. Two groups that barely spoke to each other in 1996 agreed on and developed a universal authorization form used by home health agencies and all major health plans in Massachusetts.

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References

AARP Public Policy Institute. (2001). Reforming the health care system: State profiles. Washington, DC: Author.

Farrah, L. (2001). The InterStudy Competitive Edge, 12.1. Kennebunk, ME: Mark Farrah Associates.

Massachusetts Association of Health Plans. (2001). Year end enrollment trends. Boston: Author.

Massachusetts Association of Health Plans (MAHP) and Home and Health Care Association of Massachusetts (HHCAM). (1996). Pre symposium survey results.

Massachusetts Managed Care Reform Law, chap. 141, Section 12 (2000).

Tolpin, H. (1996, March). Facilitation remarks presented at a symposium for senior management executives and clinical representatives.

U.S. Census Bureau. (2001). Health insurance coverage. Washington, DC: Author.