Uncertified Homecare: Structure and Performance. Volume 1. Abstract, ExecutiveSummary and Final Report

摘要

Home care is one of the fastest growing and potentially most important sectors ofthe health care industry in the present era of rising costs and cost containment. In addition to Medicare certified providers (CPs) of home care, there is a larger sector of uncertified providers (UPs) about which little is known. Project aims are to address four sets of questions: (1) What are the organizational characteristics (structure) of UPs in three sites and how do UPs 'perform' in terms of access, quality and financing; (2) How do UP and CP structure and performance differ; (3) What are the interrelationships among access, quality and financing; (4) What are issues, incentives and barriers concerning licensure and certification. The project identified the universe of uncertified home care providers in 3 Standard Metropolitan Statistical Areas (SMSAs): San Francisco/Oakland, CA, Philadelphia, PA, and Houston, TX. Study findings indicate that most UPs are licensed, and tax status predicts differences in their performance (e.g., access and quality).