From 1994 to 1997, staff at the California Association for Health Services (CAHSAH) constructed a uniform patient-level home health care database and developed a comprehensive patient classification system for home health care services. They also analyzed the collected data.
The California Association for Health Services, based in Sacramento, Calif., is a statewide home care association.
- The project team developed a database of more than data on more than 87,000 Medicare patients who received care from 30 providers in three states.
- There was great variation among patient groups in resource use.
- Cost differences among agencies varied more than could be attributed to case-mix differences.
- For patients who received services for fewer than 120 days, utilization and costs were substantially higher for patients in Medicare fee for service (FFS) than in all other payor categories.
- Long-term patients represented 11.6 percent of all Medicare FFS patients, but accounted for 43.4 percent of the total FFS costs.
- The findings suggest that a proposed prospective payment system for home health care may need to take into account disincentives to providers to treat long-term patients.