Quality and cost control of home care services through coordinated funding

The growing cost and demand for home care has resulted in increased concern over the quality and cost-effectiveness of care. In Tulsa, Oklahoma, local home care funders reduced the cost and enhanced the quality of home care through a system coordinating the funding and assessment of care. The foundation of this system was the funders' agreement on common definitions of services and service standards and their adoption of a uniform unit-cost reimbursement rate. Another aspect of the coordination was a joint Request for Proposals process that set out specified criteria for home care agencies seeking funds. A home care assessment team was established by Tulsa's local funders to perform ongoing monitoring and evaluation of the home care agency selected to receive funds. As a result of the coordinated funding and assessment system, the quality and efficiency of home care improved measurably, and community access to care increased.