Home health nurse patient care and coordination time. Health maintenance organization versus fee-for-service.

Home health nurse visit and care coordination time were compared between Medicare patients enrolled in an health maintenance organization (HMO) and in the traditional Medicare fee-for-service program. In home nurse visit time did not differ for the two groups. Coordination time per episode of care was approximately 40 minutes longer for an HMO patient. When home health administrators develop discounted visit rates for HMO contracts, they must include the extra coordination time in the rates.