What major change did Medicare introduce to home care when it became effective in 1966?

The major change introduced by Medicare in 1966 was the implementation of a medical model of practice in home health care. This shift meant that home health services became part of a more standardized and regulated approach to healthcare, focusing on achieving specific medical outcomes rather than just providing personal or custodial care.

In this context, the medical model emphasizes skilled nursing care, physical therapy, and other medically necessary services that are performed in the home setting. By doing so, Medicare not only expanded access to essential health services for patients who were homebound but also set a precedent for how care should be delivered and reimbursed in a home health context.

The transition to a medical model meant that care provided in the home environment was now closely linked to physician oversight and the need for clinical evaluations, thereby integrating home care into the broader healthcare system under Medicare guidelines. This approach distinguished home health care from more informal or custodial care models that were predominating before Medicare's involvement.