The Medicare and Medicaid home health benefits are extensive programs covering more than 4 million persons, costing $13 billion annually. However, these benefits have limited social work coverage, representing only 1% to 2% of all Medicare and Medicaid home health visits, and social work is not a required service under Medicaid. There has been limited research addressing home care social workers' frustrations with unmet patient needs but no research on coping strategies social workers use to deal with the devalued status of social work in home care. This article presents the results of an interview-based pilot study of the topic, using a convenience sample of 14 home care social workers in New York City interviewed in 2006. Policy makers and practitioners should take guidance from the innovator and rebel social work types and from the Hospice Medicare Benefit and create a more robust social work—based psychosocial care component in Medicare and Medicaid home health care.
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