The Impact of Hurricane Harvey on Home Health Care Delivery for Medicare Beneficiaries

<jats:p>Hurricanes can profoundly affect the delivery of home health (HH) services. We examined the impact of Hurricane Harvey on HH care in Texas, linking 2017-2018 patient-level Medicare HH claims with county-level data on disaster declarations from the Federal Emergency Management Agency. We used segmented interrupted time series to estimate monthly HH use changes among 142,416 beneficiaries in affected versus non-affected counties immediately after landfall (level change) and in its continued aftermath (trend change). HH nursing use dropped 16% immediately following hurricane and continued to decrease by 0-2%, statistically significant throughout post-Harvey period in the affected counties. However, similar impacts were also observed in non-affected counties. HH therapy use showed similar decreases, but with a smaller magnitude. Beneficiaries with the lowest function experienced significant larger immediate decreases in HH therapy use in the affected versus non-affected counties. Findings suggest the need to enhance mandatory disaster preparedness regulations in Medicare-certified HH agencies.</jats:p>