the costs of these services, Freedman and Reschovsky (1997) report that approximately 25 billion dollars per year is currently being paid for home health care services with approximately two-thirds of these patients using medicare as their primary payment source. Moreover, it is noted that national studies have shown that medicare and privately insured patients spend substantially more for home health care than do other patient groups.
The typical home health services received by older people, according to Skipwith (1994) includes personal hygiene tasks, the measurement of vital signs, and various technical tasks. Usually, this care is provided by a professional nurse, a home health aide working under the direction of a professional nurse, or both.
Research on the Effects of the Balanced Budget Act of 1997
The issue which is selected for analysis is the policy response of home health care agencies to the effects the Balanced Budget act of 1997 has had on the industry. In order to provide content to the eventual analysis of policy that will be conducted, the review of literature presented here examines articles and research addressing how the Balanced Budget Act of 1997 has affected home health care workers providing services to the frail elderly and which formulates policy recommendations based on their assessment of the nature of these effects.
In one study of the effects of the Balanced Budget Act of 1997 and its implications for home health care policy, Fogel (1998) stated that the Balanced Budget Act of 1997 has limited its Medicare payments to home health agencies. The newly mandated payments, according to Fogel (1988) require organizational policy changes on the part of home health care providers.
The need for a reorganization of service delivery in the home health care field has been echoed by other researchers. For example, Foster (1998) reported that one implication of the Balanced Budget Act of 1997 is...