More Medicare fee-for-service beneficiaries receive care in their homes from home health agencies than from any other post-acute care provider (skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals). However, when providing care in large, rural service areas with low concentrations of patients, home health agencies face additional challenges, such as greater travel and time costs. As a result, some rural beneficiaries have difficulty accessing any home healthcare, receiving specialty services, and/or receiving the appropriate amount of required services, despite historical and current incentive payments for home health agencies to encourage provision of care to rural beneficiaries. Understanding population-adjusted rates of home healthcare utilization in rural versus urban areas and intra-rural variation in discharges from acute care hospitals to home health will provide critical information on potential unmet need for rural Medicare beneficiaries.

Publications

• Variation in Use of Home Health Care Among Fee-for-Service Medicare Beneficiaries by Rural-Urban Status and Geographic Region: Assessing the Potential for Unmet Need
  Policy Brief
  WWAMI Rural Health Research Center
  Date: 02/2020
  This study describes use of home healthcare by rural-urban status and geographic region. Findings suggest geographic region drives variation more than rural-urban status. Unmet need may be highest in the most remote rural counties and rural counties within the West North Central, East North Central, Mountain, and Pacific Census Divisions.