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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Henry B. Goldberg1, Marian V. Wrobel, PhD1, Kevin E. Cahill, PhD1, and Ann Meadow, D Sc2. (1) Abt Associates Inc., 55 Wheeler Street, Cambridge, MA 02138, 617-349-2482, henry_goldberg@abtassoc.com, (2) Office of Research, Development, and Information (ORDI), Center for Medicare and Medicaid Services, 7500 Security Boulevard, C3-19-26, Baltimore, MD 02144
RATIONALE: In October 2000, Medicare payment for home health services moved to a prospective payment system (PPS). Payments are now a lump sum to cover all services provided during a 60-day period. Classification of patients into eighty home health resource groups (HHRGs), based on characteristics previously shown to predict resources used, adjust the payment to compensate for patients’ differing service needs.
The HHRGs were developed from an agency sample stratified to assure representation of different geographic regions, types of control, and affiliation. However, the analysis did not isolate effects of agency characteristics, in order to maintain neutral payment policies under Medicare. Understanding any systematic differences in practice patterns can provide insight into how differing types of agencies may be adjusting to the PPS, and what this may mean for their patients.
APPROACH: Using national Medicare claims and OASIS assessments from 1999-2000, this study uses descriptive and multivariate analyses to examine relationships between agency characteristics and home health resource use:
>Agency characteristics indicators are added to multivariate models of resource use to examine differences in practice patterns generally and for patient subgroups of interest (e.g., selected diagnoses, ADL dependency). >Agency characteristics indicators are added to models for specific service types (e.g., rehab therapy) to identify service-specific differences in patterns of use that may not be apparent in the analyses of aggregate resource use.
Learning Objectives:
Keywords: Home Care, Medicare
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Work was produced by Abt Associates Inc., Cambridge MA, under contract to the Center for Medicare and Medicaid Services
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employer