Research Alert: April 22, 2019

Differences in Care Processes Between Community-Entry Versus Post-acute Home Health for Rural Medicare Beneficiaries

Medicare beneficiaries may be admitted to home health following an inpatient stay (post-acute) or directly from the community (community-entry). An analysis of Medicare data for rural, fee-for-service Medicare beneficiaries who utilized home health from 2011 to 2013 found significant differences in care processes between community-entry and post-acute home health. Compared to post-acute home health episodes, community-entry home health episodes on average were longer; less likely to include physical, occupational, and speech therapy visits; more likely to include medical social work visits; and less likely to be initiated on the physician-ordered start date or within two days of referral. Results suggest community-entry and post-acute home health are serving different needs for rural Medicare beneficiaries, which provides preliminary support for distinguishing between the two types of episodes in payment policy reform.

Additional Resources of Interest:

• Access to Rural Home Health Services: Views From the Field
• Community Factors and Outcomes of Home Health Care for High-Risk Rural Medicare Beneficiaries
• Different Populations Served by the Medicare Home Health Benefit: Comparison of Post-Acute Versus Community-Entry Home Health in Rural Areas
• More information about the WWAMI Rural Health Research Center
• More information from the Rural Health Information Hub's topic guide: Home Health Services