Concordance between planned and approved visits during initial home care

Based on little prior information and a brief interview, the Medicare home health agency intake case manager must estimate the types and amounts of services a new client will require during the first 60 days of home care. We systematically examined the concordance between types and amounts of planned services with those actually approved and reimbursed during the first 60 days of care for a sample of 2,431 clients during 1986. Overall, the mean number of planned visits during the first 60 days was 24.76, and the mean number of approved visits was 15.95. Approved visits as a percent of planned visits averaged 64.4.