Rural Health Research Gateway

Home health

Publications

Listed by publication date. You can also view these publications alphabetically.

2006

  • Performance of Rural and Urban Home Health Agencies in Improving Patient Outcomes
    Author(s): Janet P. Sutton
    Research center: Walsh Center for Rural Health Analysis
    Topics: Home health, Medicare
    Date: 05 / 2006
    This study was conducted to determine whether rural and urban home care agencies differ in terms of patient care outcomes, and to ascertain whether there are agency characteristics that are associated with better or worse outcomes. This study found rather small differences in the quality of care provided by home health agencies in rural and urban areas. Findings from the multivariate analyses indicated that rural agencies performed better on measures of improvement in walking, transferring, and dressing, whereas urban agencies performed better on measures of improvement in pain frequency and medication management. Rural or urban location had only a modest effect on functional performance scores. Rural and urban agency differences in rates of unplanned urgent care and hospital admissions were not statistically significant after controlling for other agency characteristics, region of country and characteristics of the health care market.

2005

  • Utilization of Home Health Services Among Rural Medicare Beneficiaries Before and After the PPS
    Author(s): Janet P. Sutton
    Research center: Walsh Center for Rural Health Analysis
    Topics: Home health, Medicare Prospective Payment System (PPS), Rural statistics and demographics
    Date: 08 / 2005
    Describes a study conducted to gather information on the rural effects of the PPS, including whether the PPS contributed to changes in: (1) the demographic and clinical characteristics of home care users; (2) the likelihood of using each of six home care disciplines (aide, skilled nursing, physical therapy, occupational therapy, speech therapy and medical social work); and (3) the intensity of services. A total of 99,367 home health episodes were represented in the two years of Medicare data examined. In both study years, urban residents accounted for three-quarters of episodes, while residents of large rural counties and those of remote rural counties accounted for approximately 21 percent and 3 percent of episodes, respectively. Findings suggest that the PPS has had a mixed effect on access to home care in rural counties. Study results indicated an association between implementation of the PPS and admitting home health diagnoses, utilization and intensity of home care episodes and, for the subset of home health users admitted from an acute hospital, readmission rates.
  • Home Health Payment Reform: Trends In The Supply Of Rural Agencies And Availability Of Home-Based Skilled Services
    Author(s): Janet P. Sutton
    Research center: Walsh Center for Rural Health Analysis
    Topics: Home health, Medicare
    Report Number: Policy Analysis Brief, W Series No. 6
    Date: 03 / 2005
    Findings from this study suggest that changes in home health reimbursement were associated with dramatic reductions in the supply of home care agencies; however those reductions appear to have occurred primarily during the time in which the Interim Payment System was in place. Although proportionately fewer rural agencies closed between 1998 and 2000, the closure of a rural agency may have a greater impact on access since many communities are experiencing critical shortages of providers. In the post-PPS period, agency supply became more stable, but closure rates were higher among rural agencies.
  • Patterns Of Post-Acute Utilization In Rural And Urban Communities: Home Health, Skilled Nursing, and Inpatient Medical Rehabilitation
    Author(s): Janet P. Sutton
    Research center: Walsh Center for Rural Health Analysis
    Topics: Home health, Long term care
    Date: 03 / 2005
    Describes rural Medicare beneficiaries' patterns of post-acute utilization of home health services, skilled nursing facilities, and inpatient rehabilitation facilities. This study provides baseline data that policymakers, researchers, and others who are interested in rural health care issues may use to monitor how changes in Medicare policies affect access to post-acute care in rural areas.

2004

  • Medicare Home Health Care in Rural America (Brief)
    Author(s): Sheila J. Franco
    Research center: Walsh Center for Rural Health Analysis
    Topics: Home health, Medicare
    Report Number: Policy Analysis Brief W Series No. 1
    Date: 01 / 2004
    This study looked at the characteristics of rural Medicare beneficiaries served by urban home health agencies as compared with those served by rural agencies. Findings demonstrate that urban agencies, either directly or through their branch offices, play an important role in providing home health care to rural Medicare beneficiaries. A full report is also available.

2003

  • Medicare Home Health Care in Rural America (Full Report)
    Research center: Walsh Center for Rural Health Analysis
    Topics: Home health, Medicare
    Date: 06 / 2003
    This study looked at the characteristics of rural Medicare beneficiaries served by urban home health agencies as compared with those served by rural agencies. Findings demonstrate that urban agencies, either directly or through their branch offices, play an important role in providing home health care to rural Medicare beneficiaries. Report available on request. A policy brief is also available.

2001

  • Rural Hospitals' Ability to Finance Inpatient, Skilled Nursing, and Home Health Care
    Author(s): Jeffrey Stensland, Ira Moscovice
    Research center: Minnesota Rural Health Research Center
    Topics: Health care financing, Home health, Hospitals and clinics, Long term care, Medicare
    Date: 10 / 2001
    Surveys 448 rural hospitals to see how they are restructuring in light of the Balanced Budget Act of 1997. Among its findings: the most popular strategy for small rural hospitals is to convert to Critical Access Hospital status-35 percent of those surveyed have done so; despite the closing of some facilities, the vast majority of rural patients still have access to one or more skilled nursing facilities and one or more home health agencies; and to help preserve access to care, policy makers should consider paying a portion of the bad debt and charity care expenses that Critical Access Hospitals incur when treating non-Medicare patients.

2000

  • Rural Home Health Agencies: The Impact of the Balanced Budget Act
    Author(s): Sheila J. Franco, Joel Leon
    Research center: Walsh Center for Rural Health Analysis
    Topics: Home health, Medicare Prospective Payment System (PPS)
    Date: 04 / 2000
    This policy analysis brief examines how the characteristics of rural and urban Medicare-certified home health agencies differ, estimates the impact of interim payment system (IPS) on these agencies, and discusses policy implications for a Medicare home health prospective payment system (PPS). For a print copy of publications prior to 2004, please contact the Walsh Center at 301-951-5070.
  • Rural and Urban Patterns of Home Health Use: Implications for Access Under the Interim Payment System
    Author(s): Janet P. Sutton
    Research center: Walsh Center for Rural Health Analysis
    Topics: Home health, Medicare
    Date: 03 / 2000
    This policy analysis brief compares patterns of home health utilization among rural and urban Medicare beneficiaries in order to estimate the potential impact of an interim payment system (IPS) on access to home care in rural areas of the country. For a print copy of publications prior to 2004, please contact the Walsh Center at 301-951-5070.

This web site includes content provided by and adapted from the Maine Rural Health Research Center, University of Southern Maine under a Cooperative Agreement with the University of North Dakota.