In a recent study published in Home Health Care Management & Practice, social work researcher William Cabin reviews Medicare-certified home health agencies (HHAs).

Cabin compares two types of HHAs: non-profit HHAs and those that are private on cost, profitability and quality of care since the advent of the prospective payment system (PPS) in October 2000. Under PPS, Medicare pays HHAs a predetermined cost for services. The cost is adjusted depending on the health condition and needs of the patient.

Since 2000, when the PPS system was created, home health costs have grown by 123% from $8.5 billion in 2000 to $17.9 billion in 2013. In his findings, Cabin determined that the longer an agency has been Medicare certified, the higher its total cost per patient; the larger the number of HHAs in the state, the lower the overall quality of care and the higher the total cost per patient.