Home health care outcomes under capitated and fee-for-service payment.
In this article, case-mix-adjusted outcomes of home health care are found to be superior for Medicare fee-for-service (FFS) patients relative to Medicare health maintenance organization (HMO) patients. The superior outcomes for FFS patients were accompanied by higher utilization and cost of home health services, suggesting a volume-outcome (or dose-response) relationship that was further substantiated by within-HMO and within-FFS analyses. The findings suggest that greater attention should be paid to both outcome-based quality assurance and managed care practices that may be overly restrictive in terms of the use of home health services.
Shaughnessy
P W
PW
Center for Health Services Research, Denver, CO 80222.
Schlenker
R E
RE
Hittle
D F
DF
D002204:Capitation Fee; D003625:Data Collection; D003953:Diagnosis-Related Groups; D018588:Fee-for-Service Plans / Q000592:standards*; D006279:Health Maintenance Organizations / Q000592:standards*; D006699:Home Care Services / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000191:economics; D014481:United States