​With this issue, Home Healthcare Now marks the beginning of its 40th year in publication! When the first issue was published in September/October of 1983, the journal title was Home Healthcare Nurse. In 2015, in recognition of the interprofessional nature of home healthcare, the name was changed to Home Healthcare Now. With either title, the goal has consistently been to bring timely, evidence-based, relevant content to home healthcare professionals.

The very first issue included an article about the dreaded Diagnostic Related Groups (DRGs). In 1983, Congress amended the Social Security Act to change the way hospitals were paid for inpatient care. Prior to this Act, hospitals were reimbursed on a pay-per-service model, encouraging lengthy hospital stays and excessive diagnostic testing. Rapidly rising healthcare costs made this method of reimbursement unsustainable. Patient diagnoses were classified into 467 groups known as DRGs and hospitals were reimbursed by diagnosis rather than number of days in the hospital and/or number of procedures (blood work, xrays etc.) performed. This revolutionary change sent shock waves through hospital finance departments, but also through home care agencies who realized patients would be returning home sooner and in need of higher levels of care. What seemed an impossible expectation at the time led to highly efficient processes in patient care and management. Home care stepped into the spotlight and up to the plate. Patients discovered they liked recovering in their homes with the support of nurses, home health aides and myriad therapists. Who in 1983 could envision a patient with a hip replacement returning home the day of surgery in 2022?

Another article was about AIDS, a new, much feared and little understood disease in 1983. At that time, the origin of AIDS was unknown, and it was thought to be a disease exclusive to gay men. Mortality rates were staggering. Today we differentiate patients positive for HIV from patients with AIDS. Medication management has made HIV/AIDS a chronic disease rather than a death sentence. Most importantly, three patients with HIV/AIDS are presumed cured following stem cell transplants for acute leukemia. While this is not a cure available to everyone at this time, this exciting news is likely the beginning of a long-hoped for cure.

We can only imagine what the next 40 years will bring to home care and hospice. Whatever changes may come, Home Healthcare Now will be here, leading the conversation, educating, and advocating.

Best wishes,