PATIENT-LEVEL COST OF HOME HEALTH-CARE UNDER CAPITATED AND FEE-FOR-SERVICE PAYMENT

This article examines costs far a national sample of 1,260 Medicare pa tients receiving home health care from 38 home health agencies. If use s data from a study that compares home health care provided to Medicar e beneficiaries in health maintenance organizations (HMOs) and the tra ditional fee-for-service (FFS) system. The major findings indicate sig nificantly lower costs, based on fewer home health visits, for HMO pat ients compared to FFS patients, even after adjustment for case mix and other factors. However, FFS patients also attain better outcomes, sug gesting that HMOs may provide too few visits to home health patients. At the same time, the number of visits to FFS patients may be greater than is necessary to achieve the better FFS outcomes.