The impact of Medicare home health policy changes on Medicare beneficiaries: part II.

This brief presents the results of a follow-up study (Murtaugh et al., 2003) on the effects of the Balanced Budget Act of 1997 on Medicare home health service use and beneficiary outcomes.[The results of the initial study (McCall et al., 2001) were discussed in a Spring 2003 policy brief and fact sheet.] The 2003 study found that the new payment systems have had a significant impact on the Medicare home health benefit: utilization declined, aggregate payments and payments per visit decreased (and then increased), the mix of services shifted, and the types of patients served appears to have changed. These results show that policy goals-in this case attempting to limit the use of the Medicare home health benefit while shifting services towards skilled care-can be instituted through changes in the payment system, though it is important to examine the impact of changes for possible unintended effects. Further study on the sustained impact of the current payment system-particularly on quality of care-is still needed.