Rural Home Health Services – Resources

Rural and Urban Differences in Care Provided by Home Health Agencies in the United States: A Review of the Literature
Explores the differences in care outcomes for rural and urban home health agencies (HHAs). Discusses some of the barriers faced by rural HHAs, such as overcoming long distances, increased costs, and workforce limitations, among others.
Author(s): Denise D. Quigley, Ashley M. Chastain, Jung A. Kang, et al.
Citation: The Journal of Post-Acute and Long-Term Care Medicine, 23(10), 1653.e1-1653.e13
Date: 10/2022
view details

Home Health Agencies Used Multiple Strategies to Respond to the COVID-19 Pandemic, Although Some Challenges Persist
Presents results of a survey of home health agencies (HHAs) conducted between September through December 2021 to explore the challenges they faced during the COVID-19 pandemic. Discusses challenges related to staffing, infection control, the use of telehealth, and the adequacy of emergency preparedness plans, as well as challenges specific to rural HHAs. Provides recommendations for how the Centers for Medicare & Medicaid Services (CMS) can help HHAs prepare for and respond to current and future infectious disease outbreaks and changes to the home health care landscape.
Date: 10/2022
Sponsoring organization: Office of Inspector General (HHS)
view details

Report to Congress: Unified Payment for Medicare-Covered Post-Acute Care
Presents a prototype for a Unified Post-acute Care (PAC) prospective payment system (PPS) that would set payment for PAC services on the basis of the clinical characteristics of the patient rather than the type of provider. Details the structure of the prototype and the data used in the analyses to design and calibrate the PPS. Explores key considerations for unifying PAC payment, such as cost-sharing and value-based payment. Includes data on PAC provider characteristics, including facility size and rural status, as well as rural payment adjustments.
Additional links: Appendices
Author(s): Benjamin Silver, Anne Deutsch, Nicole Coomer, et al.
Date: 07/2022
Sponsoring organizations: Centers for Medicare and Medicaid Services, RTI International
view details

Left Behind Again: Rural Home Health Services in a Medicaid Pediatric Accountable Care Organization
Examines differences in pediatric home healthcare utilization among rural and urban children in a Medicaid pediatric Accountable Care Organization (ACO) in Ohio. Analyzes overall differences in healthcare use and annual trends in home health use by rurality and Medicaid eligibility group. Discusses how these findings could inform state policies and future research.
Author(s): Rose Y. Hardy, Gilbert C. Liu, Kimberly J. Conkol, Sean P. Gleeson, Kelly J. Kelleher
Citation: Journal of Rural Health
Date: 2021
view details

The Impact of Medicare's Rural Add-on Payments on Supply of Home Health Agencies Serving Rural Counties
Examines how Medicare rural add-on payments affected the number of home health agencies serving rural counties between 2002-2017. Compares the population-adjusted number of home health agencies in urban, urban-adjacent non-urban-adjacent rural counties during periods with add-on payments and without add-on payments. Discusses implications for revised and future add-on payments to maintain or increase the supply of rural home health agencies.
Author(s): Tracy M. Mroz, Davis G. Patterson, Bianca K. Frogner
Citation: Health Affairs, 39(6), 949-957
Date: 06/2020
view details

There's No Place Like Home: Home Health Care in Rural America
Recording of testimony by providers of rural home health care and representatives of home health and hospice organizations, in a hearing held by the United States Senate Special Committee on Aging on February 12, 2020. Addresses challenges including workforce shortages and limitations in Medicare coverage for needed services.
Additional links: Testimony of Francis Adams, Testimony of Leigh Ann Howard, Testimony of Warren Hebert, Testimony of William A. Dombi
Date: 02/2020
Sponsoring organization: U.S. Senate Special Committee on Aging
view details

Rural Post-Acute Care: Healthcare Leaders Offer Practical Solutions to Workforce Challenges
Describes methods for preparing and supporting healthcare workers who provide post-acute care in rural areas. Highlights programs that empower and train staff, maximize community partnerships, involve community health workers, and use telemonitoring.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 05/2018
Sponsoring organization: Rural Health Information Hub
view details

Rural Post-Acute Care: Improving Transitions to Enhance Patient Recovery
Highlights approaches that are improving patient transitions from acute care to post-acute care (PAC) in rural settings. Features a tertiary facility's communication with skilled nursing facilities in Tennessee and Kentucky, a Nebraska Critical Access Hospital's swing bed program, and a home health agency serving rural Maine.
Author(s): Jenn Lukens
Date: 05/2018
Sponsoring organization: Rural Health Information Hub
view details

Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching
Describes a pilot study using community volunteers trained as health coaches to assist rural older adults with chronic diseases discharged from home health services in effectively managing their chronic condition, with the intent to reduce their hospital readmission and emergency department use.
Author(s): Cheryl Dye, Deborah Willoughby, Begum Aybar-Damali, Carmelita Grady, Rebecca Oran, Alana Knudson
Citation: International Journal of Environmental Research and Public Health, 15(4), 660
Date: 04/2018
view details

State Operations Manual Appendix B - Guidance for Surveyors: Home Health Agencies
Presents interpretive guidelines clarifying statutory and regulatory requirements for home health agencies.
Sponsoring organization: Centers for Medicare and Medicaid Services
view details