Wood Johnson Foundation under Grant Numbers 13779 and

The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outcomes of home health care. Definitions are provided for a number of terms that relate to quality of care, outcome measures, risk adjustment, and quality assur-ance (QA) in home health care. The goal is to provide an overview of a potential systemwide approach to outcome-based QA that has its basi