Table 2.
Agency-Level Service Attributes by Medicare HHA Supply Change Category 1996–1999
| HHA Supply Change Category 1996–1999 | |||||||
|---|---|---|---|---|---|---|---|
| Variable | Market Exit | Service Area Contraction | Service Area Expansion | Service Area Stable | New Market Entrant | Total 1996 | Total 1999 |
| Beneficiary service attributes | |||||||
| Number of HHAs | 2,143 | 1,027 | 942 | 5,052 | 870 | 9,164 | 7,891 |
| Percentage of total 1996 | 23.4 | 11.2 | 10.3 | 55.1 | |||
| Percentage of total 1999 | 13.0 | 11.9 | 64.0 | 11.0 | |||
| Medicare beneficiaries served 1996 | 558,493 | 343,651 | 167,120 | 2,925,699 | 3,994,963 | ||
| Beneficiary users as a percentage of total 1996 | 14.0 | 8.6 | 4.2 | 73.2 | 100.0 | ||
| Beneficiaries served in 1996 in dropped zip codes | 558,493 | 124,851 | 4,122 | 106,803 | 794,269 | ||
| Beneficiaries of dropped zip codes as percentage of total 1996 | 100.0 | 36.3 | 2.5 | 3.7 | 19.9 | ||
| Medicare beneficiaries served 1999 | 99,163 | 362,048 | 2,403,016 | 131,585 | 2,995,812 | ||
| Beneficiary users as a percentage of total 1999 | 3.3 | 12.1 | 80.2 | 4.4 | 100.0 | ||
| Beneficiaries served in 1999 in added zip codes | 3,200 | 142,054 | 116,591 | 131,585 | 393,430 | ||
| Beneficiaries of added zip codes as percentage of total 1999 | 3.2 | 39.2 | 4.7 | 100.0 | 13.1 | ||
| Travel distance attributes* | |||||||
| Mean distance from HHA to beneficiary in miles 1996 | 20.9 | 12.9 | 10.9 | ||||
| Mean distance from HHA to beneficiary in miles 1999 | 16.3 | 18.5 | 10.9 | ||||
| Mean change in distance in miles | −4.7 | 5.6 | 0.0 | ||||
| Medicare service attributes | |||||||
| Mean beneficiaries served 1996 | 504 | 243 | 581 | ||||
| Mean beneficiaries served 1999 | 161 | 493 | 478 | ||||
| Percentage of HHAs with increase in Medicare users | 1.5 | 92.9 | 26.3 | ||||
| Mean percentage change in beneficiaries served | −64.2 | 258.0 | −8.9 | ||||
| Mean total Medicare visits 1996 | 41,132 | 17,891 | 35,056 | ||||
| Mean total Medicare visits 1999 | 6,331 | 22,129 | 17,271 | ||||
| Percentage of HHAs with increase in Medicare visits | 0.8 | 61.4 | 9.8 | ||||
| Mean percentage change in total Medicare visits | −80.8 | 193.0 | −38.8 | ||||
| Mean visits per Medicare user 1996 | 93 | 94 | 72 | ||||
| Mean visits per Medicare user 1999 | 35 | 50 | 38 | ||||
| Percentage of HHAs with a decline in visits per user | 94.6 | 86.3 | 94.5 | ||||
| Mean percentage change in visits per Medicare user (%) | −54.2 | −32.9 | −39.2 | ||||
| HHA staffing levels† | |||||||
| Mean RN FTEs 1996 | 17.98 | 7.93 | 17.43 | ||||
| Mean RN FTEs 1999 | 10.36 | 11.25 | 15.33 | ||||
| Mean change in RN FTEs 1996–1999 (%) | −42.4 | 41.9 | −12.0 | ||||
| Mean CNA FTEs 1996 | 18.9 | 7.88 | 17.14 | ||||
| Mean CNA FTEs 1999 | 11.9 | 9.55 | 12.78 | ||||
| Mean change in CNA FTEs 1996–1999 (%) | −37.0 | 21.2 | −25.4 | ||||
Notes:
*
Only HHAs that were active in both 1996 and 1999 were used in computations of mean distance traveled and Medicare service attributes (n=6,251). Distance is measured as straight-line distance between centroids of agency and beneficiary residence zip codes.
†
Only active HHAs with staffing data for both 1996 and 1999 were used in computations of mean staffing levels (n=6,203). FTE staff include employees and contract nonemployees.
HHA, home health agencies; RN, registered nurse; FTE, full-time equivalent.