Home health

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2024

Estimated Impacts of Multiple Payment Policies on Rural-Serving Home Health Agencies
Policy Brief
WWAMI Rural Health Research Center
Date: 07/2024
This brief examines the estimated impact of three Medicare payment policy changes on home health agency (HHA) reimbursement by rural-serving status, geographic location, and select HHA characteristics.

2022

Quality of Home Health Agencies Serving Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 02/2022
This policy brief describes the quality of home health agencies (HHAs) by rural-serving status. While quality of patient care star ratings were not associated with rural-serving status, rural HHAs and urban HHAs that serve rural patients had higher patient experience star ratings than urban HHAs that do not serve rural patients.

2021

Post-acute Care Trajectories for Rural Medicare Beneficiaries: Planned Versus Actual Hospital Discharges to Skilled Nursing Facilities and Home Health Agencies
Policy Brief
WWAMI Rural Health Research Center
Date: 03/2021
This policy brief describes trajectories for rural Medicare beneficiaries following hospital discharge, including differences between planned and actual discharge to skilled nursing facilities and home health agencies. More than 40% of beneficiaries for whom home health care was indicated did not receive care from a home health agency.

2020

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.

2019

Differences in Care Processes Between Community-Entry Versus Post-Acute Home Health for Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 04/2019
This study describes home healthcare processes for rural Medicare beneficiaries who are admitted from the community (community-entry) versus those who are admitted following an inpatient stay (post-acute). Care processes include timely initiation of care, length of stay, and services provided (e.g., physical therapy, medical social work).

2018

Service Provision and Quality Outcomes in Home Health for Rural Medicare Beneficiaries at High Risk for Unplanned Care
Journal Article
WWAMI Rural Health Research Center
Date: 06/2018
This study examined service provision and quality outcomes among rural Medicare beneficiaries who used home health from 2011-2013 and were at high risk for unplanned care. More skilled nursing visits and visits by more types of providers were associated with higher hospital readmission and emergency department use and lower community discharge.

2017

Home Is Where the Heart Is: Insights on the Coordination and Delivery of Home Health Services in Rural America
Policy Brief
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 08/2017
Access to home health in rural areas is an important public policy concern, particularly with the growing number of older adults residing in rural America. This qualitative study seeks to better understand how home health services are provided in rural areas, and identifies facilitators and barriers to providing care.

2016

Community Factors and Outcomes of Home Health Care for High-Risk Rural Medicare Beneficiaries
Policy Brief
WWAMI Rural Health Research Center
Date: 10/2016
Outcomes of care vary by region of the country for rural Medicare beneficiaries receiving home health services for high-risk conditions such as heart failure. Those in the East South Central and West South Central Census Divisions had lower rates of community discharge and higher rates of hospital readmission and emergency department use.
Access to Rural Home Health Services: Views From the Field
Report
WWAMI Rural Health Research Center
Date: 02/2016
Access to home health care can be challenging for rural Medicare clients. Key informants for this study detailed obstacles, including financial, regulatory, workforce, and geographic issues. Rural communities will likely benefit from payment reforms that reward quality services while providing incentives to use best practices in home health care.
Disparities in Home Health Service Providers Among Medicare Beneficiaries with Stroke
Journal Article
University of South Carolina Rural Health Research Center
Date: 01/2016
Examines the intensity of home health services, by the number of visits and service delivery by rehabilitation specialists, among Medicare beneficiates with stroke. There were no significant rural-urban differences in the number of home health visits, but rural residents were less likely to receive services from rehabilitation specialists.

2013

Are Primary Care Practices Ready to Become Patient-Centered Medical Homes?
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 2013
Measures the readiness of rural primary care practices to be eligible as patient-centered medical homes (PCMHs) by comparing PCMH readiness scores with metropolitan and nonmetropolitan primary care practices.

2006

Performance of Rural and Urban Home Health Agencies in Improving Patient Outcomes
NORC Walsh Center for Rural Health Analysis
Date: 05/2006
This study was conducted to determine whether rural and urban home care agencies differ in terms of patient care outcomes and to ascertain whether there are agency characteristics that are associated with better or worse outcomes.

2005

Utilization of Home Health Services Among Rural Medicare Beneficiaries Before and After the PPS
NORC Walsh Center for Rural Health Analysis
Date: 08/2005
This report describes a study conducted on the rural effects of the PPS, including whether the PPS contributed to changes in the demographic and clinical characteristics of home care users, the likelihood of using each of six home care disciplines, and the intensity of services.
Home Health Payment Reform: Trends in the Supply of Rural Agencies and Availability of Home-Based Skilled Services
NORC Walsh Center for Rural Health Analysis
Date: 03/2005
Findings from this study suggest that changes in home health reimbursement were associated with dramatic reductions in the supply of home care agencies; however those reductions appear to have occurred primarily during the time in which the Interim Payment System was in place.
Patterns of Post-Acute Utilization in Rural and Urban Communities: Home Health, Skilled Nursing, and Inpatient Medical Rehabilitation
NORC Walsh Center for Rural Health Analysis
Date: 03/2005
This report describes rural Medicare beneficiaries' patterns of post-acute utilization of home health services, skilled nursing facilities, and inpatient rehabilitation facilities.

2004

Medicare Home Health Care in Rural America
Policy Brief
NORC Walsh Center for Rural Health Analysis
Date: 01/2004
This study looked at the characteristics of rural Medicare beneficiaries served by urban home health agencies as compared with those served by rural agencies.

2003

Medicare Home Health Care in Rural America (Full Report)
NORC Walsh Center for Rural Health Analysis
Date: 06/2003
This study looked at the characteristics of rural Medicare beneficiaries served by urban home health agencies as compared with those served by rural agencies.

2000

Rural Home Health Agencies: The Impact of the Balanced Budget Act
Policy Brief
NORC Walsh Center for Rural Health Analysis
Date: 04/2000
This policy analysis brief examines how the characteristics of rural and urban Medicare-certified home health agencies differ, estimates the impact of interim payment system on these agencies, and discusses policy implications for a Medicare home health prospective payment system.
Rural and Urban Patterns of Home Health Use: Implications for Access Under the Interim Payment System
Policy Brief
NORC Walsh Center for Rural Health Analysis
Date: 03/2000
This policy analysis brief compares patterns of home health utilization among rural and urban Medicare beneficiaries in order to estimate the potential impact of an interim payment system on access to home care in rural areas of the country.