Performance Improvement 2004. Maximizing the Cost Effectiveness of Home Health Care (HHC)


This study sought to examine the following hypotheses: (1) volume-outcome relationships are present in HHC for common patient conditions, (2) upper and lower volume thresholds define the range of services most beneficial to patients, and (3) a strengthened physician role and better integration of HHC with other services during an episode of care can optimize patient outcomes while controlling costs. Rapid growth in home health use has occurred despite limited evidence about the necessary volume of HHC needed to achieve optimal patient outcomes, and whether or not it substitutes for more costly institutional care. The following outcomes were found: 1) limitations in activities of daily living (ADLs) were significantly greater for the high-volume groups, these patients had a greater prevalence of chronic conditions, and their institutional utilization within the 14 days prior to admission was less likely to be an acute-care hospital, indicating the more postacute nature of the low-volume groups; 2) the general case mix difference was consistent with the greater use of aide services for high-volume patients; 3) preliminary analyses of outcomes suggested relatively few differences in outcomes by volume, after controlling for condition.

PIC ID: 7179
Agency Sponsor: CMS, Office of Research, Development & Information
Federal Contact: Meadow, Ann, 410-786-6602
Performer: Center for Health Policy Research, Washington, DC

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