Medicare cuts hurt access to home care
Study finds sickest patients suffer most
Medicare cuts for home care services enacted under the Balanced Budget Act of 1997 are jeopardizing the health of the sickest, most vulnerable home care patients, according to a new study recently released by the George Wash ington University Medical Center in Washing ton, DC.
"An Examination of Medicare Home Health Services: A Descriptive Study of the Effects of the Balanced Budget Act Interim Payment System on Access to and Quality of Care" was sponsored in part by the National Association of Home Care in Washington, DC.
And the results are . . .
The study, which analyzed data from 28 home care agencies in nine states, concludes that:
• As many as 50% of the nonprofit home health agencies in the study must subsidize care for Medicare patients by using funds from their endowments or direct contributions, indicating that for many patients, Medicare payments do not cover the actual cost of providing care.
• Nearly all home health agencies in the study reported making significant reductions in clinical and administrative staff in an effort to contain costs under the Medicare cuts. Skilled nursing staff declined by 23% since 1994, leaving fewer home care professionals to meet the needs of a growing elderly population.
• Home care agencies in the study are reducing admissions of patients who will be either too costly or too demanding on remaining clinical staff. Researchers found that diabetics, particularly complex diabetics, were the most affected by changes in admission practices that restricted or reduced levels of care.
• The number of Medicare beneficiaries the agencies in the study treated dropped by 30% from 1996 to 1998.
Researchers note that a further 15% reduction in Medicare payments to home care agencies is scheduled for Oct. 1, 2000. They predict that these additional cuts will further exacerbate existing problems and put the health of Medicare beneficiaries at even greater risk.
(For more information, visit www.nahc.org.)
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content