Market Changes in the Supply and Use of Home Health Services: 1996-1999

Past studies by federal agencies examined the impact of the Balanced Budget Act of 1997 policies on beneficiaries and providers. While documenting changes in the supply of home health agencies (HHAs), these studies concluded that agency closings did not cause a shortage of Medicare home health providers and that beneficiaries' access to services were not generally affected. The research for this report built on these prior studies, and examined, in greater detail, dynamic responses of HHAs within delineated health services market areas. The authors analyze changes between 1996 and 1999 in market entry and exit of HHAs, as well as changes in the expansion or contraction of service areas by ongoing agencies. They then relate home health utilization changes to such supply changes within health services market areas. [87 PDF pages]