Attempt to Standardize Home Health Care

A pending Medicare rule set to go into effect on April Fools Day will require home health agencies to have a face-to-face meeting with prospective clients. Medicare beneficiaries will have to see a doctor 90 days before or 30 days after starting home health services in order for the home health agency to get reimbursed. Predictably, those agencies and some hospital systems are up in arms about it. For the former, the reasons are obvious; for the latter, modifications in patient discharge planning could result in major increases in services rendered, affecting acute care costs and care delivery. These concerns are a little hyperbolic and really have no merit in this attempt to criticize a Medicare provision meant to standardize patient disposition into a care area that is hardly scrutinized by the feds and rife with the potential for fraud.^[1] Home health benefits under Medicare are wickedly all over the map with respect to quality of care delivery and payment for that care. In spite of initial complaints from providers and provider organizations of ”excessive” and “overburdensome” bureaucracy and paperwork, this rule is a small step in the right direction.