Competition and Gaming Behavior by Medicare Home Health Agencies in the United States

Hyunjee Kim, Bingxiao Wu, Jeah Jung

Research output: Contribution to journalArticle

Abstract

Under the Medicare home health prospective payment system, agencies could make large profits by targeting the 10th therapy visit. The objective of this study is to examine the influence of market competition on home health agencies’ targeting the 10th therapy visit. This article uses changes in competition rates within each market over time to examine whether home health agencies were more likely to target the 10th visit under greater competition. No significant associations were found between competition and agencies’ targeting behavior on average, but competition effects on targeting behavior were significantly greater for freestanding agencies that were likely to be in relatively financially disadvantageous positions. These findings suggest that competition might increase financially unstable agencies’ 10th-visit targeting behavior, potentially leading to unnecessary Medicare spending.

Original languageEnglish (US)
Pages (from-to)63-69
Number of pages7
JournalHome Health Care Management and Practice
Volume29
Issue number2
DOIs
StatePublished - May 1 2017

Keywords

  • agency type
  • market competition
  • Medicare
  • Medicare home health care
  • practice pattern
  • therapy visits

ASJC Scopus subject areas

  • Leadership and Management
  • Community and Home Care
  • Public Health, Environmental and Occupational Health

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