title: Misalignment between medicare policies and depression care in home health care: home health provider perspectives.
abstract: Semistructured interviews with nurses working for home health care agencies in five states raise serious questions about the deleterious effects of Medicare policies and procedures on depression care. The agencies have strong incentives to limit nursing time in a given payment episode and to increase volume, making it difficult to provide high-quality depression care for homebound patients. Some nurses felt forced to "abandon" many patients with depression. The authors call for incremental policy changes in several key areas.
authors.affiliation: Dr. Bao, Ms. Eggman, and Dr. Richardson are with the Department of Healthcare Policy and Research, and Dr. Bruce is with the Department of Psychiatry, all at Weill Cornell Medical College, New York City (e-mail: yub2003@med.cornell.edu).
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Dr. Bao, Ms. Eggman, and Dr. Richardson are with the Department of Healthcare Policy and Research, and Dr. Bruce is with the Department of Psychiatry, all at Weill Cornell Medical College, New York City (e-mail: yub2003@med.cornell.edu).
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Eggman
authors.affiliation: Dr. Bao, Ms. Eggman, and Dr. Richardson are with the Department of Healthcare Policy and Research, and Dr. Bruce is with the Department of Psychiatry, all at Weill Cornell Medical College, New York City (e-mail: yub2003@med.cornell.edu).
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Richardson
authors.affiliation: Dr. Bao, Ms. Eggman, and Dr. Richardson are with the Department of Healthcare Policy and Research, and Dr. Bruce is with the Department of Psychiatry, all at Weill Cornell Medical College, New York City (e-mail: yub2003@med.cornell.edu).
authors.forename: Martha L
authors.initials: ML
authors.lastname: Bruce
mesh_terms: D003866:Depressive Disorder / Q000191:economics / Q000451:nursing; D018574:Home Care Agencies / Q000191:economics / Q000592:standards; D006699:Home Care Services / Q000191:economics / Q000592:standards; D006801:Humans; D006278:Medicare / Q000191:economics / Q000592:standards; D014481:United States