Home Health Agency Applications

The home health care industry has been growing steadily in the United States. Home health care is defined as “skilled nursing, therapy, aide service, or medical social work provided to beneficiaries in their homes” (MedPAC, 2005a, p 106). The beneficiaries must be confined to the home and need intermittent, part-time home health care services. In the early to mid 1980s, the Center for Medicare and Medicaid Services (CMS), then Health Care Financing Administration (HCFA), had very strict eligibility criteria and annual limits on coverage for home health care. Annual spending only increased at a rate of 1% from 1985 to 1988. A court decision broadened the guidelines for home health coverage in 1989, and it was transformed from a benefit primarily for short-term post acute hospital care to a longer term chronic disease care. Afterward, home health care spending grew at an annual rate of 30% from 1989 to 1997 (Government Accounting Office (GAO), 2000).