The impact of the Balanced Budget Act of 1997 on home healthcare agencies and nurses.

"Medicare home health agencies are facing a regulatory purgatory as measures to reduce home health spending by about $16 billion over five years take effect with little government guidance. Home health providers are grappling with new surety bond requirements, the banning of venipuncture as a qualifying procedure for other home health services, and an interim payment system to scale back reimbursement levels before a prospective payment system takes effect in fiscal year 2000" (Cassil, 1998). The challenges of surviving and conquering all of the current issues facing home healthcare nurses and agencies seem overwhelming. All of these legislative and regulatory issues with the resulting financial and clinical implications are occurring as agency staff and administrators continue to provide quality home healthcare services to patients of all ages. Please share your strategies for meeting the challenges of 1998 with the editor.