Date of Award

1998

Document Type

Thesis

Degree Name

Master of Science in Health Management

First Advisor

Betty LeMasters

Second Advisor

Lynn Mark

Third Advisor

Levi S. Kirkland

Abstract

This thesis will focus on the changes in health care delivery in the United States and how case management and home health care agencies have impacted upon it. The quality and cost-effectiveness of case management and home health care delivery will also be explored.

As we approach the twenty-first century, the focus of health care delivery is changing rapidly. The health care delivery system has undergone major changes and has had a tremendous impact on the development of case management and home health care agencies. These changes are affecting, and will affect health care consumers and the delivery of home care services. ln general, research attributes those changes as including: the evolution of rapidly advancing technology, scientific breakthroughs, the implementation of governmentally-imposed policies, changes in the economy, and altered lifestyles of health care consumers. In addition, research has indicated that there is a significant rise in the costs of health care today. Because of the multitudinous changes within our health care delivery system and the rising costs of health care, enormous interest has been created. Health care professionals, tl1e federal government, insurance companies, and consumers are primarily interested in the establishment of comprehensive programs and methods designed to facilitate the improved delivery of cost-effective health care. The quest for finding solutions to the delivery of quality health care while simultaneously containing cost has also extended to Wall Street investors, independent providers, and health care consumers. Similarly, health care consumers are searching for new alternatives for regaining, restoring and maintaining health, or minimizing the effects of illness.

Based upon research and consumer health needs, the necessity becomes evident of: developing a structural and educational framework for establishing a case management and home health care agency; designing programs to target special health problems and high risk populations; discussing the elements of program or service expenses which can be considered; illustration of the magnitude of cost savings which can be achieved; provision of an ongoing system for monitoring the economic and quality impacts of a case management and home health care agency; and, the offering of a methodology for reproducing the cost savings data in other case management and home care settings.

The purpose of this study is to develop a business plan for a case management and home health care agency positioned within a large city in a metropolitan area. It is anticipated that the business plan will illustrate the requirements for operating a case management and home health care agency while epitomizing quality, cost-effective health care services. Journal articles and published studies were the primary source of secondary data. Guidelines from the United States Small Business Administration and Missouri Department of Home Health Licensing and Certification requirements were utilized.

It is hoped that those who utilize the case management and home health care agency will benefit from its services.

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