Abstract
Most older Americans want to age in place.1 The Medicare home health benefit is a prominent national policy supporting older Americans at home and provides for visiting nurse and therapist services from home health agencies (HHAs). In 2012, Medicare spent $18.2 billion on HHAs; 3.5 million beneficiaries received care.2 Home health can help struggling patients get support in the community and can enable successful transitions home from institutional care. However, numerous concerns have been raised about the home health benefit, including fraud, geographic variation in utilization, and poor coordination with primary medical care.3- 5 This uncertainty is untimely, as more than 70 million adults will join Medicare between 2011 and 2030 with the hope of receiving care at home. It is time to develop a stronger home health option.
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