DIFFERENCES ACROSS PAYORS IN CHARGES FOR AGENCY-BASED HOME HEALTH-SERVICES - EVIDENCE FROM THE NATIONAL HOME AND HOSPICE CARE SURVEY

Objective. To investigate charge and payment differentials for home he alth services across different payers. Data Sources. The 1992 National Home and Hospice Care Survey, a nationally representative survey of h ome and hospice care agencies and their patients, collected by the Nat ional Center for Health Statistics. Study Design. We compare the avera ge charge for a Medicare home health visit to the average charge for p atients with other sources of payment. In making such comparisons, we control for differences across payers in service mix and agency charac teristics. Principal Findings. Agencies charge various payers differen t amounts for similar services, and Medicare is consistently charged m ore than other payers. Conclusions. Findings imply the potential exist ence of payment differentials across payers for home health services, with Medicare and privately insured patients likely to be paying more than others for similar services. Such conclusions raise the possibili ty that, as in other segments of the healthcare market, cost-shifting and price discrimination might exist within the home health industry F uture research should explore these issues, along with the question of whether Medicare is paying too much for home health services.