The growth in home health care in the United States since 1970, and th
e exponential increase in the provision of Medicare-covered home healt
h services over the past 5 years, underscores the critical need to ass
ess the effectiveness of home health care in our society. This article
presents conceptual and applied topics and approaches involved in ass
essing effectiveness through measuring the outcomes of home health car
e. Definitions are provided for a number of terms that relate to quali
ty of care, outcome measures, risk adjustment, and quality assurance (
QA) in home health care. The goal is to provide an overview of a poten
tial systemwide approach to outcome-based QA that has its basis in a p
artnership between the home health industry and payers or regulators.