A range of medical services can be provided in the home setting, allowing patients to be discharged from hospital or inpatient rehabilitation settings more quickly. Medicare reimburses for six types of home health care: skilled nursing, physical therapy, occupational therapy, speech pathology, medical social work, and home health aide services. In November 2011, the Centers for Medicare and Medicaid Services modified Medicare reimbursement for home health care, seeking to control costs by reducing inflation-associated adjustments in charges. In the past, changes in reimbursement may have affected rural home health care agencies more adversely than those in urban areas. The purpose of the current report is to describe the status of home health care service delivery in the rural U.S. in 2008, before passage of the Patient Protection and Affordable Care Act and related efforts.
We used Medicare Compare Home Health Agency files for 2008 to examine two aspects of home health care (HHC) across the United States: HHC agency availability and quality of services provided. Home health agencies are required to report the geographic areas they serve by ZIP Code; they are also required to report quality results across a range of 12 outcomes. This report is based on agency reports; we did not independently verify that services were actually provided within all listed areas.
Janice C. Probst, PhD
South Carolina Rural Health Research Center