Forum Session

Access to Home Health Services under Medicare's Interim Payment System
July 13, 1999


Nora Super


Participants at this Forum session explored the impact of the interim payment system (IPS) for home health agencies established under the Balanced Budget Act of 1997 (BBA). The system was put in place in 1997 until a prospective payment system — as required by the BBA — could be developed (scheduled for October 1, 2000). Since implementation of the interim system, a number of home health agencies had closed and some reports had suggested that new payment limits restricted access to care for patients with very costly needs. This meeting examined the most recent studies conducted by the Medicare Payment Advisory Commission, the General Accounting Office, and the Urban Institute on the impact of the IPS on access to home health care, including home health agencies' responses to the payment system and its impact on provider availability and, ultimately, access to care for the sickest or most expensive populations. These presentations were followed by a response panel of experts representing the perspectives of government, the home health industry, and Medicare beneficiaries.


Murray Ross, PhD, Executive Director, Medicare Payment Advisory Commission; Laura Dummit, Associate Director, Health Financing and Public Health, General Accounting Office; Barbara Gage, PhD, Senior Research Associate, Urban Institute; Robert Wardwell, Director, Division of Community Post-Acute Care, Center for Health Plans and Providers, Health Care Financing Administration; Nancy King, Vice President, Home and Community Based Services, Ohio Presbyterian Retirement System; Peter Cobb, Executive Director, Vermont Assembly of Health Health Agencies; Hilary Sohmer Dalin, Staff Attorney, Center for Medicare Advocacy

Related Materials

More information available in the accompanying publication, Issue Brief No. 744.

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