The Impact of the Interim Payment System on Ohio Home Healthcare Agencies
Review TypeNone: Degree-based Submission
Repository Posting Date2019-09-18T13:31:37Z
Author(s)Gerding, Abigail A.
Author DetailsAbigail A. Gerding, RN, PhD
Lead Author Sigma AffliationMu Alpha
Level of EvidenceObservational
Research ApproachQuantitative Research
CINAHL HeadingsHome Health Agencies--Economics; Medicare--Economics; Health Care Delivery--Trends; Home Health Agencies; Reimbursement Mechanisms; Medicare; Health Care Delivery
In order to decrease the escalating costs of home care and extend the solvency of the Medicare trust fund, major changes in home care reimbursement were mandated by the Balanced Budget Act of 1997. The Interim Payment System, required by the Balanced Budget Act, altered the method of payment for home healthcare agencies from a retrospective cost-based system to a per-episode aggregate limit as home healthcare agencies prepared for a Prospective Payment system to be implemented by October of 2000. This study examined the impact of the Interim Payment System on home healthcare agencies across Ohio. As a retrospective, explanatory study designed to identify associations and differences between home healthcare delivery systems, caseload and utilization variables from (pre-IPS) 1996 and (post-IPS) 1999, alterations in home healthcare agencies were described. Descriptive statistics were used to explore the data. T-tests were used in assessing significant group differences in continuous measures and chi-square test for group differences on nominal or ordinal data. There were 402 agencies in the Ohio market in 1996 and 326 agencies in the Ohio market in 1999. 277 agencies functioned in the market both in 1996 and 1999. 125 agencies left the market by 1999 and 49 agencies entered the market by 1999. Changes that were identified included, less reliance on Medicare, emphasis placed on skilled nursing and physical therapy, and high cost ancillary services were decreased. Age and gender remained stable with slight increases in clients less than 64 years old. Case mix had sharp decreases as mean number of clients increased and costs and visits decreased by 1999. This study demonstrated that as IPS was implemented changes in home healthcare delivery and patient caseload resulted in a shift of utilization variables. Although some agencies left the market, and services were decreased, agencies have reported that these changes have triggered efficiencies and improvement in clinical practice pattern. Given the continued economic environment to reduce costs and utilization, home healthcare administrators will need to persist in the mechanisms that will deliver quality care to those clients who need it while developing strategies to streamline care and productivity.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3039472; ProQuest document ID: 251692257. The author still retains copyright.
Advisor(s)Salsberry, Pamela J.
Degree GrantorThe Ohio State University
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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