Assessing Potential Unmet Need for Home Healthcare in Rural Areas

Research center:
Lead researcher:
Tracy Mroz, PhD, 206.598.5396,
Project funded:
September 2016
Project completed:
February 2020

More Medicare fee-for-service beneficiaries receive care in their homes from home health agencies than from any other post-acute care provider (skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals). However, when providing care in large, rural service areas with low concentrations of patients, home health agencies face additional challenges, such as greater travel and time costs. As a result, some rural beneficiaries have difficulty accessing any home healthcare, receiving specialty services, and/or receiving the appropriate amount of required services, despite historical and current incentive payments for home health agencies to encourage provision of care to rural beneficiaries. Understanding population-adjusted rates of home healthcare utilization in rural versus urban areas and intra-rural variation in discharges from acute care hospitals to home health will provide critical information on potential unmet need for rural Medicare beneficiaries.