Managing uncompensated home care.

The purpose of this study was to determine the strategies used by managers of public health nursing and visiting nurse associations to cope with increased demand for uncompensated home care. A questionnaire was mailed to all public health nursing and visiting nurse associations in the upper midwest. Of the 161 agencies reporting their experience with uncompensated care demand, 129 experienced an increased demand for uncompensated care. Public health nursing and small agencies were more likely to experience increased demand for uncompensated care. Use of cost reduction, revenue enhancement, and quality assurance strategies varied by demand for uncompensated care status as well as by agency size and type. Managers of large and medium agencies and visiting nurses associations were more likely to use the identified strategies. Six strategies were used by more than 50% of the responding agencies.