Abstract
An exploratory study investigated ethical conflicts over access to services for elderly patients and social work practice activities within the context of the Medicare Prospective Payment System (PPS) in home health care. Questionnaires (n = 77) were distributed to attendees at the annual conference of the American Network of Home Health Care Social Workers in October, 2001 (response rate = 43%). A majority of the respondents rated the impact of the ethical conflict on elderly patients as “somewhat” or “very” negative. A decrease in the number of social work home visits since the implementation of PPS was reported by 63% of respondents. Implications for practice, education, and research are discussed.