The Balanced Budget Act: effects on home care beneficiaries and providers.

The Balanced Budget Act of 1997 (BBA 97) requires major changes in the way Medicare reimburses home care agencies. Two independent organizations analyzed the effects of the BBA 97 on home care; the analyses reveal no surprises. The new policies give agencies incentives to reduce their volume of care; as a result, high-use patients are likely to suffer most. This tightening of payments and the new incentives may lead to adverse effects on both access to and quality of care.