Sponsored by the Research on Evaluation TIG
George Grob, Center for Public Program Evaluation, georgefgrob@cs.com
In the early 1990’s, the Medicare program began implementing a new benefit to provide in-home care to home-bound patients. This program built on a tradition of dedicated visiting nurses, active since the 1900s. However, the benefits soon became industrialized, with new chains of providers organized to exploit the new benefit. Annual Medicare expenditures mushroomed from $3 billion to $18 billion. Auditors found that 40% of Medicare payments were improper. Others raised questions about the quality of care. The Office of Inspector General’s Office of Evaluation and Inspections undertook a series of studies that led to reforms which ultimately saved $50 billion and promoted better care. Follow-up studies concluded that Medicare beneficiaries truly needing home health care were able to get it. It is this series of evaluations, along with auditors and investigators, that yielded these results. This presentation will address the exemplary features of the studies.