Medicare beneficiaries may be admitted to home health following an inpatient stay (post-acute) or directly from the community (community-entry). This study examined differences between post-acute and community-entry home health for rural, fee-for-services beneficiaries. The proportion of community-entry episodes were examined by type of rural geography and region. Predictors of community-entry, including clinical and non-clinical beneficiary characteristics, community health resources, and Medicaid programming were explored. Differences in service provision between community-entry and post-acute home health were also examined. Results provided critical information on how rural Medicare beneficiaries were utilizing the home health benefit, which helped inform continued efforts to revise the home health prospective payment system.

Publications

• Differences in Care Processes Between Community-Entry Versus Post-Acute Home Health for Rural Medicare Beneficiaries
  Policy Brief
  WWAMI Rural Health Research Center
  Date: 04/2019
  This study describes home healthcare processes for rural Medicare beneficiaries who are admitted from the community (community-entry) versus those who are admitted following an inpatient stay (post-acute). Care processes include timely initiation of care, length of stay, and services provided (e.g., physical therapy, medical social work).
• Different Populations Served by the Medicare Home Health Benefit: Comparison of Post-Acute Versus Community-Entry Home Health in Rural Areas
  Policy Brief
  WWAMI Rural Health Research Center
  Date: 07/2018
  This study describes differences between rural, fee-for-service Medicare beneficiaries who are admitted to home health from the community (community-entry) and those who are admitted to home health following an inpatient stay (post-acute) in terms of their clinical and non-clinical characteristics as well as the communities in which they live.