“They Don’t Seem to Care”: A Qualitative Study of Home Care Social Workers Views on Medicare Advantage

Objective: To determine if there is agreement—between a systematic literature review and home care social worker interviews—that current low utilization of Medicare home health social work services has an adverse impacts impact on patient care. Methods: This is a qualitative study based on in-person interviews of a convenience sample of 36 home care social workers from 6 different home health agencies in New York City between April 9, 2026, and May 29, 2026. It is a follow-up to a similar study on home care nurses view in this Journal, published online in June 2026. Results: Four major themes emerged, with social workers feeling, like nurses: (1) the Medicare Advantage prior authorization process denials are frequent and adversely impact patient care; (2) Medicare Advantage Plans use of home health decreases the amount of home health visits; (3) decreased Medicare Advantage home health visits disproportionately affect social work, which is the lowest volume service in traditional Medicare home health and (4) decreased Medicare Advantage home health visits per patient increase the likelihood of patients developing further psychosocial and medical complications. Conclusions: The current study reinforces the need for: (a) government sponsored robust research to have a more valid and reliable idea of where relevant policy changes should be made, and (b) statutory and regulatory action to address the low utilization of Medicare home health social work services and its adverse impacts on patient care.