Abstract:

Federal expenditures for home health care have been increasing at an annual rate of 30% per year since 1974, and are predicted to continue to increase more rapidly than expenditures for other health services in the future. This predication is based on: the aging population, increases in medical technology and the impact of government regulatory mechanisms which encourage growth and competition in the home health industry. In order to develop effective regulatory policies for the future it is necessary to understand the effect of past policies on home health care services. This is a descriptive study of one state's experience with a changing regulatory environment over a ten year period of time. Data from the Massachusetts Department of Public Health's Annual Reports for Home Health Agencies was used to describe industry growth and change and the effect these had on the accessibility, quality and efficiency of service delivery from 1980 to 1990. Results suggest dramatic changes in the industry, with strong evidence of agencies' competitive behaviors, improved patient access to most services, changes in staffing patterns and concerns for quality of care.