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Abstract
Data from two states with different reimbursement policies for home health service were compared. The analysis indicates that changes in Medicaid policy encouraging the use of home health aid service as a long term maintenance program was effective in obtaining treatment for persons at greater risk of institutionalization. The analysis also indicates that differences in Medicaid reimbursement policies have a more general impact on the overall caseload and pattern of care provided in the home health care system. The findings have both theoretical and policy. relevance in terms of program and policy implementation, understanding service networks, and professional organizations.