An occupational therapy regimen of approximately 8 to 9 visits was also the norm for those receiving speech therapy or occupational therapy, contributing to a total average of 54 visits for the first group and 47 visits on average for the second group. Because patients can use Home Care near Breinigsville PA for many years, a patient's classification in a given calendar year depends both on the source of income for each of their episodes and on the number of episodes they have in that year. The CMS cite the MedPac analysis, which revealed decades of overpayments in home health care because agencies reduced the average number of visits per period to reduce costs for the period and cost growth in recent years was lower than the annual percentage of updating home health care payments. A similar decrease in the number of visits to caregivers per episode among patients admitted to the community and patients receiving therapy assisted by other care has not contributed to the increase in number of patients admitted to the community.
However, the prevalence of speech therapy is low even for men (0.39 versus 0.14 average visits for men and women, respectively). Patients with similar periods of home health use have comparable characteristics regardless of their source of income, but there are greater differences between patients with multiple episodes of care. And while there were greater differences between the two groups of long-term patients than between the two groups of short-term patients, the patterns of use of home care and types of visits become more similar over time in long-term users, so the source of income became less relevant as the beneficiaries continued to use home care for an extended period of time. On average, long-term CAP users had more visits of all types of visits in the first episode compared to long-term users entering the community, but the biggest difference in types of visits occurred in therapy visits (10.2 for long-term CAP users versus 8.2 for long-term users entering the community).The greater difference in clinical severity between the two groups of patients with CAP compared to the two groups of patients admitted to the community probably reflects the fact that fewer patients with CAP have a second episode of home health care and only do so if they are very sick, while more patients admitted to the community tend to have longer periods of home health (Figure III).
This suggests a possible explanation for their use of unspecialized care: that is, these patients can enter and leave home care by bicycle, resulting in less specialized care throughout their episode. The average CHC score increased in both groups of patients, with relatively similar trends over the period in both groups. Consultations and expenses for occupational therapy were high in the case of patients with paralysis limitations or speech limitations, while speech therapy increased mainly in the case of patients with speech limitations and, secondly, in the case of patients with speech limitations. Visits to home health workers and medical social services were relatively stable from the first episodes of the period to the last episodes for both groups.
The Centers for Medicare and Medicaid Services (CMS) of the Department of Health and Human Services adjusted payments for episodes of home health care, making some types of patients more financially attractive to home health agencies (HHA) and other types of patients were less so. If the beneficiary was covered for part of a stay in an acute care hospital, long-term hospital, rehabilitation hospital, or SNF for 14 days prior to the start of the home health care episode, the episode was classified as a PAC episode; otherwise, the episode was classified as an episode admitted to the community.
