What the GAO found

The Office of the Inspector General’s General Accounting Office’s (GAO) study, which surveyed discharge planners from 82 hospitals and representatives from 21 local aging organizations in seven states, concluded that "neither agency closures nor the interim payment system [IPS], with less than a year’s implementation experience, has significantly affected the capacity of the home health industry to provide services or beneficiary access to care."

(See tables for survey findings, pp. 164-167.)

Further, the report did not substantiate the home health care industry’s belief that more agencies were closing their doors as a direct result of IPS. Instead, the GAO study found that agencies were going out of business for a variety of reasons, and that despite 554 voluntary and 206 involuntary agency closings between October 1997 and June 30, 1998, the total number of agencies nationwide had increased during that period.

Some patients hard to place

The GAO reported no substantial problems in access to home health care, but acknowledged that overall, even though discharge planners reported no significant change in agencies’ behavior, these same people had found those beneficiaries requiring expensive, long-term care were more difficult "to place in home health services."


Anita Bradberry, Executive Director, Texas Association for Home Care, 3737 Executive Center Dr., Suite 151, Austin, TX 78731. Telephone: (512) 338-9293.

John C. Gilliland, JD, Law Office of John C. Gilliland II, 2670 Chancellor Dr., Suite 290, Crestview Hills, KY 41014. Telephone: (312) 850-7500.

Thomas Hoyer, Director, Chronic Care Purchasing Policy Group, Center for Health Plans and Providers, Health Care Financing Administration, 7500 Security Blvd., Baltimore, MD 21244. Telephone: (410) 786-3000.

Carol Rodat, Executive Director, Home Care Association of New York State Inc., 21 Elk St., Albany, NY 12207. Telephone: (518) 426-8764.

Michael Sullivan, Executive Director, Indiana Association for Home and Hospice Care Inc., 8888 Keystone Crossing, Suite 1000, Indianapolis IN 46240. Telephone: (317) 844-6630.