Medpar

Studies show that 10% of readmissions of Medicare beneficiaries hospital early could have been avoided. "There were 301,017 readmissions that were clinically related" (Norbert I. Goldfield, 2008) with a previous admission was classified as being avoidable or unnecessary. Statistics show that hospitals that have been effective in creating evacuation plans experience lower rates of readmission. Although the need for case management services has increased over the last decade, the concept is not new. "Speeches originated in the late 1800s in the ideologies of the coordination of human services, conservation of public funds, and care of the poor and sick." (Hall, Carswell, Walsh, Huber & Jampol, 2002) However, organizations in decline in the early 1900s only to reappear during the Great Depression. "Traditional social work intervention [] based on [] poor people who were struggling with basic survival needs" (Hall, Carswell, Walsh, Huber & Jampol, 2002)

Currently, one in five patients leave the hospital in an acute care hospital cost Medicare more than 17 billion dollars annually. In 2008, "(19.6%) of 11,855,702 Medicare beneficiaries who had been released from a hospital were re-hospitalized within 30 days." (Jencks, Williams, and Coleman, 2009) There is a direct relationship between rising rates of readmission and socioeconomic status of a patient. People living alone have an education of less than 12 years, low income, chronic or mental illness or who do not support system are less likely to comply with their escape plan. According to the 2008 report from the U.S. Census, the national education level of people who were not institutionalized and more than 64 years 3.9 million are 12 years or less from education. (U.S. Census Bureau, 2008)

As the baby boomers retire from the need for case management is increasing. Policy makers are eager to implement new health reforms. Obama has promised to have a bill before Congress by the end of March 2010 to meet the needs of aging Americans who are disadvantaged, or chronic mental disorders. About one in three Americans will experience some form of mental disorder at some point in their lives, according to one estimate, one in every 6.4 adults currently suffering from a form of mental illness. (Boyle & Callahan, 1993) One area of concern is the impact of hospital readmissions of elderly patients at the beginning of the budget for health care. "The cost of care for these patients whose disease is episodic and treatable totaled 136.1 million billion dollars a year." (Boyle & Callahan, 1993) The first step in reducing this cost is to reevaluate the case.

It is suggested that this increase is due to the number of Medicare beneficiaries receiving home care inadequate. Could it be because there are too many programs and changes to choose? On average, each Medicare beneficiary "have the choice of at least 41 plane (except special needs plans available to qualifying sub-groups only), plus a wide range of Medicare Prescription standalone drug plans. "(Gold, 2009)

According to Medicare Provider Analysis and Review (MEDPAR) file for 2009, under the current policy of Medicare services, home health care consists of skilled nursing, physiotherapy, occupational therapy, speech therapy, support service and medical social work. (P. 201)

Conclusion: The home health agencies have reduced the number of services to their patients receiving the same reimbursement. Under the Medicare fee for the service policy of the basket, only agencies must meet the minimum requirements. They have adapted their services to increase the maximum production while maintaining the standards. Moving from the current policy at an average rate for services.