Differences Across Payors in Charges for Agency-Based Home Health Services

Evidence from the National Home and Hospice Care Survey

by Vicki A. Freedman, James D. Reschovsky


Purchase Print Copy

 FormatList Price
Add to Cart Paperback20 pages Free

Using the 1992 National Home and Hospice Care Survey, a representative survey of home and hospice care agencies and their patients, the authors investigated charge and payment differentials for home health services across different payors. They compared the average charge for a Medicare home health visit to the average charge for patients with other sources of payment, controlling for differences across payors in service mix and agency characteristics. Results indicated that agencies charge various payors different amounts for similar services, and Medicare is consistently charged more than other payors. This implies the potential existence of payment differentials across payors for home health services, with Medicare and privately insured patients likely to be paying more than others for similar services. Such conclusions raise the possibility that, as in other segments of the healthcare market, cost-shifting and price discrimination might exist within the home health industry. Future research should explore these issues, along with the question of whether Medicare is paying too much for home health services.

Originally published in: Health Services Research, v. 32, no. 4, October 1997, pp. 433-452.

This report is part of the RAND Corporation Reprint series. The Reprint was a product of the RAND Corporation from 1992 to 2011 that represented previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints were formally reviewed in accordance with the publisher's editorial policy and compliant with RAND's rigorous quality assurance standards for quality and objectivity. For select current RAND journal articles, see External Publications.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.