Home health PPS makes discharge planning harder.

HCFA's new prospective payment system for home health represents a challenge to hospital case managers as well as the home health industry. With funding reduced and documentation increased, many home health agencies find themselves scrambling to serve patients and break even financially. Case managers have had to worry about whether agencies will be able to accept the patients that hospitals send their way. Agencies are anxious about the demands on their time and productivity. It's been a tough adjustment with a long learning curve, and things are still in flux.