Implications for Home Health and Hospice Care under the New Prospective Payment System

Abstract

The purpose of this article is to discuss the impact of new federal regulations on home health care. Because the primary changes focus on payment method, aspects of the effect of the prospective payment system (PPS) on home health care patients and providers are explored. The historical background and contemporary rationale for reform are offered, and the issues of quality and ethics are addressed. The article concludes with thoughts on the importance of maintaining the integrity of Medicare/Medicaid programs and a challenge to the idea that a dichotomy exists between cost containment and high quality in health care. With full cooperation and commitment by all involved parties, a balance can be struck in which higher-quality care is provided in a cost-effective manner.

Keywords

abuse cost containment ethics fraud prof it quality

Get full access to this article

View all access options for this article.

References

1. Carpenter-Mason B . Quality Assurance: Toward a Paradigm of Universality. A Philosophical Tool for Health Care Practitioners, Managers, Administrators, and Policy Makers. Ann Arbor, Mich: UMI Bell & Howell; 1995.

2. National Association of Home Care. HCFA data show growth in Medicare home care benefit. Home Care News. 1996; April: 12.

3. National Committee to Preserve Social Security and Medicare. Squires P. Patients or prof its: President's home health care initiative and the commission is coming. Secure Retirement. 1997;6:7–12.

4. Health Care Financing Administration. Conditions of participation and HIM 11/HIM 21 guidelines. Home Health Agency Manual. 1997; April: sections 106, 204, 206. 240.

5. Office of the Inspector General. Medicare hospice conditions of participation. HSQB Memo. June 27, 1997.

6. National Hospice Organization. NHO Bull. July 31, 1997.

7. Berke D . The revised unified PPS proposal: Some frequently asked questions. Caring Mag. 1997; February: 28–37.

8. Office of the Federal Register. Public health. CFR 42 part 430 to End, and Part 1000 to 10007.19. Revised October 1, 1996.

9. Hippocratic oath.

10.

10. Public Law No. 97-248, 1982.