The sources identified as major contributors to the BBA were: politicians of all political parties; home wellness care performance administrators, geriatric health care providers, insurance companies, and senior citizens groups.
The conducted outline provided data to show that the largest contribution made to the BBA consisted of politicians whose actions, in general, slowed the dictate of growth in Medicare spending and, in that locationfore, in spending relate to home health care. It was noted that the cuts in expenditures firenot be state to interfere with home health service livery so much as to mandate that the industry make changes in its policy and operations.
It was also noted that the home health care industry itself attempted to develop a payment architectural plan to be considered by the politicians developing the BBA but plan had several(prenominal) flaws and was therefore rejected, a fact that most probably contributed to many an(prenominal) of the changes and cuts that were eventually passed. With respect to insurance agencies, the analysis revealed that they lobbied for and received increase private insurance options for Medicare beneficiaries. Both advantages and disadvantages were said to be associated with these red-hot options. Advantages included
That community health nursing goals are going to be affected by these changes cannot be denied. Attaining the goals of providing cost-effective yet comprehensive services at a profit is going to require some work. However, there are a number of steps which community health nursing organizations can take to make sure that their goals are still met.
This failure of the home health care industry to pass its plan and/or provide a executable plan, according to Forster (1998) is one of the contributors to the significant reduction in reimbursement that occurred in the BBA, a reduction requiring agencies to reduce costs per visits, number of visits per patient, and tote up costs per patient. Further, certain services were eliminated as qualifying for Medicare monies (e.g.
, venipuncture), and so forth. The need for so many changes in the industry's systems, staffing and service delivery is likely to make it difficult for community health nurses works in the home health care field in that they are bound to have far fewer resources that they can use to meet patient needs.
In the past, Fogel (1998) states, home health care agencies were much more focused on the quality and the efficiency of service delivery with costs being solitary(prenominal) a secondary or tertiary consideration. It is stated that straightway costs must be considered to such an extent that home health care providers should consider changing their organizational charge so as to reflect a certain piece of cost-consciousness.
The typical home health services received by older people, according to Skipwith (1994) includes personal hygiene tasks, the measurement of life-sustaining signs, and various technical tasks. Usually, this care is provided by a professional person nurse, a home health aide working chthonic the direction of a professional nurse, or both. Recently, with the passage of the equilibrate Budget Act of 1997, the extent to which older people go forth be provided with needed home health care has been of huge concern because
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