This article uses the first national survey of home health agencies and their patients to characterize the complete length-of-use distribution for an elderly admissions cohort. Of the 26 million older Americans admitted to home health agencies in 1992, 36 percent received care for at least three months, 22 percent for at least six months, and 15 percent for at least one year. Analyses suggest that one-year limits on Medicare's home health benefit would have affected a relatively small percentage of new admissions but would have amounted to approximately 300,000 beneficiaries in 1992. In contrast, proposals to limit Medicaid would have affected a more substantial proportion of home health agency admissions but only a relatively small number of older Americans. Such length-of-use limits would also disproportionately affect those at highest risk for nursing home admission: very old, unmarried, minority women with relatively unstable chronic conditions.
Originally published in: Gerontologist, v. 39, no. 1, February 1999, pp. 16-24.
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