Remodeling Home Care: Making the Transition From Fee-For-Service to Managed Care

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  • Edition: 1st
  • Format: Hardcover
  • Copyright: 1999-12-01
  • Publisher: Routledge

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The driving influence of managed care and cost containment is causing home care organizations to reconceptualize their roles in the health care delivery system while stimulating massive changes in agency structure, operations, and services. Medicare-certified home health agencies, which have flourished under a per-visit, fee-for-service reimbursement model, are increasingly delivering care under managed care reimbursement models. Conducted at this pivotal point in time, the book examines the intersection of two rapidly growing health care sectors: home health and managed care. The environment surrounding the transition from traditional reimbursement to managed care is uncertain and rapidly changing. Strategies organizations are using to cope with this uncertainty and HHA administrators' perceptions of the two greatest impacts of managed care are described. Despite considerable variation in agency characteristics, more similarities than differences are found among HHAs. The research concludes thatmarket and environment pressures within heavily HMO-penetrated communities encourage all HHAs to become similar, regardless of whether the HHAs have managed care contracts.

Table of Contents

Tables and Figures
Organizational and Management Responses to Competition
Significance of the Study
Review of the Literature
Home Care Agencies in the United States
A Brief History of Home Care's Evolution
The Changing Reimbursement Environment for Home Care
Variations in Home Health Utilization
Utilization, Access, Outcomes and Cost Effectiveness
Fragmentation in the Structure of Home Care Services
DME and Home Infusion
Managed Care and Home Care
Economics and Home Care
Organizational Theory and Home Care
Organizational Structure
Organizational Relationships
Organizational Stability and Change
Research Question and Hypotheses
Study Population and Data Sources
Sampling Procedures
Types and Sources of Data
Data Collection Issues
Method of Analysis
Financial Issues
Agency Characteristics and Structure
Services and Utilization
Management and Operations
Study Conclusions and Implications
Study Participants and Data Issues
Summary, Discussion and Research Agenda for Four Key Areas
Financial Issues
Agency Characteristics and Structure
Services and Utilization
Management and Operations
Policy Implications and Future Research
Table of Contents provided by Publisher. All Rights Reserved.

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