The ongoing challenge of defining quality

Home care professionals want to provide high-quality care, and their rate of financial reimbursement is one of the variables that substantially affects their ability to do so. How will the advent of prospective payment, and the accompanying incentive to limit care, influence the quality of care? Clearly, agencies find themselves in a difficult position. Unless home health agencies are willing to stipulate that they had been previously providing unnecessary care, they would be disingenuous to suggest that quality will not be affected. Furthermore, for an agency to believe that quality has not been compromised in the face of evidence to the contrary could be seen as an institutional form of cognitive dissonance.