Patient-Level Home Health Care Outcomes Secondary to the Balanced Budget Act of 1997

Abstract

The National Association for Home Care estimated 26% of all home health agencies (HHAs) have gone out of business since October 1997 when Medicare began to change the funding structure for home health care reimbursement. This study aims to answer two questions: Did HHAs that went out of business abandon patients? and Are HHAs that remained in business providing less-than-adequate services? Telephone interviews were conducted with 64 randomly selected elders receiving home care services during the funding transition from fee-for-service to an interim payment system. The findings indicate that HHAs that closed down primarily transferred their patients to other agencies and that 22% of patients experienced an increase in the number of hospital admissions following the funding structure transition. These preliminary results indicate that no substantial ill-effects have come to this sample of home health care patients as a result of the Balanced Budget Act of 1997.