The Omnibus Reconciliation Act of 1980 and Its Effects on Home Health Care

An Historical Perspective on Home Care Policy

“…In light of estimates about the potential costs of liberalizing bene fits, it is surprising in the restrictive budget environment of the period that any action was taken. As it turned out, with one exception the sub sequent impact of the legislation was probably overestimated by most of those involved (Pillemer and Levine 1981).…”

“…Only later would less restrictive models for the chronically impaired elderly and nonelderly command serious policy attention. Pillemer and Levine 1981). Still, conviction remained wide spread that public home health care benefits were too restrictive and that more home care agencies and personnel were needed to stem the rising tide of demand for institutional care.…”

“…By mid-decade, the number of for-profit agencies re ceiving Medicare reimbursement would increase six-fold (Benjamin 1984). There was considerable worry and some evidence (never entirely convincing) that proprietaries delivered more expensive care and were less likely to accept Medicaid clients than other agencies (Pillemer and Levine 1981;Benjamin 1986). Arguments about the place of profit in home care would become even more relevant later in the decade, as the number of proprietaries grew to one-third of all Medicare-certified home health agencies (Silverman 1990;Kenney and Dubay 1992).…”