The regulatory structure of home health care in the United States

Home health care in the United States is highly developed involving, for example, complex therapies and durable medical equipment. Access to home care has been shaped by government reimbursement policies requiring recipients to be homebound and in need of intermittent services under medical direction. Due to strict and extensive documentation for reimbursement the Medicare regulatory structure has stifled innovation in the field of home care. Other factors affecting the provision and growth of home care services include the Joint Commission on Accreditation of Health Care Organizations, changes in hospital reimbursement policies, and the role of physicians in integrating and coordinating home care services.