Yale Study: Home Health Accessibility Varies Greatly Nationwide

The availability of home health care increased nationwide between 2002 and 2015, though patients living in certain regions of the U.S. continue to enjoy greater access to home health agencies, according to a recent study from researchers at the Yale School of Public Health.

For the study, researchers surveyed 15,184 Medicare-certified home health agencies included in the Centers for Medicare & Medicaid Services (CMS) Home Health Compare system. Together, the 15,184 agencies serve 97% of ZIP codes nationwide.

The number of Medicare-certified home health agencies in the U.S. has grown from approximately 7,500 in 2000 to more than 12,000 in 2015, the researchers determined.


The number of home health patients visiting these agencies, meanwhile, increased from 2.5 million in 2000 to 3.5 million in 2013. During this time, Medicare paid almost $28 billion for nearly 123 million patient visits.

Overall, as the number of ZIP codes without home health care declined from 2002 through 2015, the availability of home health care increased. Still, home health care accessibility continues to vary greatly, depending on patients’ geographic location.

The northeast, west and south Atlantic regions of the country had lower home health care availability than regions in the central United States, the researchers determined.


Regions with a larger senior population, a higher median income, more households without a car, increased rates of obesity, reduced access to stores, greater inactivity and higher proportions of Hispanic, non-Hispanic black and non-Hispanic white populations were more likely to have greater availability of home health care, the researchers found.

“The persistent variation in the availability of home health care nationwide highlights opportunities to expand future services to improve care of the aging population,” said Judith Lichtman, senior author of the paper and chair of the Department of Chronic Disease Epidemiology at Yale.

The study was published in the Journal of the American Geriatrics Society.

Written by Mary Kate Nelson

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