Any attempt to characterize the needs of home care patients is challenged by the volatile home care environment. The Balanced Budget Act of 1997 restricted Medicare reimbursement for home health care in an effort to
curb rising Medicare costs. Our sample was accrued during this period of constriction in Medicare spending. How
these changes, as well as Medicare’s recently implemented
home care prospective payment system, affect the needs
and treatment options for older patients is not yet known.