For-profit medicare home health agencies' costs appear higher and quality appears lower compared to nonprofit agencies

Health Affairs

Volumn 33, Issue 8, 2014, Pages 1460-1465

  Cabin, William ^a,b   Himmelstein, David U ^c   Siman, Michael L ^d   Woolhandler, Steffie ^b  

^a TEMPLE UNIVERSITY   (United States)

^b CITY UNIVERSITY OF NEW YORK   (United States)

^c CITY UNIVERSITY OF NEW YORK   (United States)

^d Youth Consultation Service Center   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMPARATIVE STUDY; HEALTH CARE COST; HEALTH CARE MANAGEMENT; HEALTH CARE QUALITY; HOME CARE; HOME HEALTH AGENCY; HOSPITALIZATION; HUMAN; MEDICARE; COST; ECONOMICS; HEALTH CARE FACILITY; NON PROFIT ORGANIZATION; PROSPECTIVE PAYMENT; PROSPECTIVE STUDY; STANDARDS; UNITED STATES;

COSTS AND COST ANALYSIS; HEALTH FACILITIES, PROPRIETARY; HOME CARE AGENCIES; HOSPITALIZATION; HUMANS; MEDICARE; ORGANIZATIONS, NONPROFIT; PROSPECTIVE PAYMENT SYSTEM; PROSPECTIVE STUDIES; QUALITY OF HEALTH CARE; UNITED STATES;

EID: 84905986016     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2014.0307     Document Type: Article

References (29)

1. Aaronson WE, Zinn JS, Rosko MD. Do for-profit and not-for-profit nursing homes behave differently? Gerontologist. 1994;34(6):775-86.
2. Carlson MD, Gallo WT, Bradley EH. Ownership status and patterns of care in hospice: results from the National Home and Hospice Care Survey. Med Care. 2004;42(5): 432-8.
3. Harrington C, Woolhandler S, Mullan J, Carrillo H, Himmelstein DU. Does investor ownership of nursing homes compromise the quality of care? Am J Public Health. 2001;91(9):1452-5.
4. Himmelstein DU, Woolhandler S, Hellander I, Wolfe SM. Quality of care in investor-owned vs notfor-profit HMOs. JAMA. 1999; 282(2):159-63.
5. Devereaux PJ, Choi PT, Lacchetti C, Weaver B, Schünemann HF, Haines T, et al. A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals. CAMJ. 2002;166(11):1399-406.
6. Devereaux PJ, Schünemann HJ, Ravindran N, Bhandari M, Garg AX, Choi PT, et al. Comparison of mortality between private for-profit and private not-for-profit hemodialysis centers: a systematic review and meta-analysis. JAMA. 2002;288(19): 2449-57.
7. Devereaux PJ, Heels-Ansdell D, Lacchetti C, Haines T, Burns KE, Cook DJ, et al. Payments for care at private for-profit and private not-forprofit hospitals: a systematic review and meta-analysis. CAMJ. 2004; 170(12):1817-24.
8. Woolhandler S, Himmelstein DU. Costs of care and administration at for-profit and other hospitals in the United States. N Engl J Med. 1997; 336(11):769-74.
9. Woolhandler S, Himmelstein DU. The high costs of for-profit care. CAMJ. 2004;170(12):1814-5.
10. Clarfield AM, Ginsberg G, Rasooly I, Levi S, Gindin J, Dwolatzky T. Forprofit and not-for-profit nursing homes in Israel: do they differ with respect to quality of care? Arch Gerontol Geriatr. 2009;48(2): 167-72.
11. Medicare Payment Advisory Commission. Report to the Congress: Medicare payment policy [Internet]. Washington (DC): MedPAC; 2012 Mar [cited 2014 Jun 12]. p. 211-24. Available from: http://medpac.gov/ documents/mar12_entirereport.pdf
12. Reschovsky JD, Ghosh A, Stewart KA, Chollet DJ. Durable medical equipment and home health among the largest contributors to area variations in use of Medicare services. Health Aff (Millwood). 2012;31(5): 956-64.
13. US District Court, District of Vermont. Glenda Jimmo et al. v. Kathleen Sebelius, Secretary of Health and Human Services: order granting final approval of settlement agreement and directing entry of final judgment [Internet]. Rutland (VT): The Court; 2013 Jan 24 [cited 2014 Jun 20]. Available from: http:// www.medicareadvocacy.org/wpcontent/ uploads/2013/01/Order-Granting-Final-Approval.012413.pdf
14. Pear R. Settlement eases rules for some Medicare patients. New York Times. 2012 Oct 22.
15. National Association for Home Care and Hospice. Basic statistics about home care: updated 2010. Washington (DC): The Association; 2011.
16. Senate Finance Committee. Staff report on home health and the Medicare therapy threshold. Washington (DC): The Committee; 2011 Sep.
17. Medicare Payment Advisory Commission. Report to the Congress: Medicare payment policy [Internet]. Washington (DC): MedPAC; 2013 Mar [cited 2014 Jun 12]. p. 187-206. Available from: http://www.medpac.gov/documents/Mar13_entire report.pdf
18. To access the Appendix, click on the Appendix link in the box to the right of the article online.
19. Nuccio EJ, Richard AA, Hittle DF. Home health agency quality measures: logistic regression models for risk adjustment [Internet]. Baltimore (MD): Centers for Medicare and Medicaid Services; 2011 Aug 15 [cited 2014 Jun 12]. Available from: https://www.cms.gov/Medicare/ Quality-Initiatives-Patient-Assessment-Instruments/Home HealthQualityInits/downloads/ HHQILogisticRegressionModels forRiskAdjustment.pdf
20. Mukamel DB, Fortinsky RH, White A, Harrington C, White KM, Quyen N-M. The policy implications of the cost structure of home health agencies. Medicare and Medicaid Research Review [serial on the Internet]. 2014 [cited 2014 Jun 12]. Available from: http://www.cms.gov/mmrr/Downloads/ MMRR2014_004_01_a03.pdf
21. Government Accountability Office. Medicare: rationale for higher payment for hospital-based home health agencies. Washington (DC): GAO; 1992. (Report No. GAO/HRD-92-24).
22. Vladeck BC. Testimony on Medicare payment for home health agency and skilled nursing facility services [Internet]. Washington (DC): Department of Health and Human Services; 1997 Feb [cited 2014 Jun 12]. Available from: http://www.hhs.gov/asl/ testify/t960723a.html
23. Levit K, Smith C, Cowan C, Lazenby H, Sensenig A, Catlin A. Trends in U.S. health care spending, 2001. Health Aff (Millwood). 2003;22(1): 154-64.
24. McCall N, Petersons A, Moore S, Korb J. Utilization of home health services before and after the Balanced Budget Act of 1997: what were the initial effects? Health Serv Res. 2003;38(1 Pt 1):85-106.
25. Murkofsky RL, Phillips RS, McCarthy EP, Davis RB, Hamel MB. Length of stay in home care before and after the 1997 Balanced Budget Act. JAMA. 2003;289(21):2841-8.
26. Rosenau PV, Linder SH. The comparative performance of for-profit and nonprofit home health care services in the US. Home Health Care Serv Q. 2001;20(2):48.
27. Jung K, Shea D, Warner C. Agency characteristics and changes in home health quality after Home Health Compare. J Aging Health. 2010; 22(4):454-76.
28. Decker FH. Profit status of home health care agencies and the risk of hospitalization. Popul Health Manag. 2011;14(4):199-204.
29. Haldiman KL, Tzeng HM. A comparison of quality measures between for-profit and nonprofit Medicarecertified home health agencies in Michigan. Home Health Care Serv Q. 2010;29(2):75-90.