HOME HEALTH-CARE OUTCOMES UNDER CAPITATED AND FEE-FOR-SERVICE PAYMENT

In this article, case-mix-adjusted outcomes of home health care are fo und to be superior for Medicare fee-for-service (FFS) patients relativ e to Medicare health maintenance organization (HMO) patients. The supe rior outcomes for FFS patients were accompanied by higher utilization and cost of home health services, suggesting a volume-outcome (or dose -response) relationship that was further substantiated by within-HMO a nd within-FFS analyses. The findings suggest that greater attention sh ould be paid to both outcome-based quality assurance and managed care practices that may be overly restrictive in terms of the use of home h ealth services.