Strategic Planning in Post-Acute Care

Strategic Planning in Post-Acute Care

Strategic Planning in Post-Acute Care

EBSCO : eBook Collection (EBSCOhost) – printed on 4/18/2019 5:23 PM via WESTERN KENTUCKY UNIV AN: 1843079 ; Harrison, Jeffrey P..; Essentials of Strategic Planning in Healthcare Account: s8993066.main.ehost

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Introduction

This chapter discusses trends and factors affecting strategic planning in the post-acute care (PAC) industry. PAC providers offer important recuperation and rehabilitation services to Medicare beneficiaries after discharge from an acute care hospital. PAC providers include skilled nursing facilities (SNFs), home health agencies (HHAs), inpatient rehabilitation facilities (IRFs), and long-term care hospitals (LTCHs). In 2013, Medicare’s payments to more than 29,000 PAC providers totaled $59 billion, more than doubling since 2001. Medicare has a responsibility to ensure access for beneficiaries, appropriately reimburse providers for the patients they treat, and control costs for the beneficiary and taxpayer alike. Patient utilization of PAC is affected by local practice patterns, the availability of PAC in a market, patient and family preferences, and financial arrangements between a PAC provider and the referring hospital. Because PAC can be appropriately provided in a variety of settings, Medicare ideally would pay for PAC using one payment system with payments based on patient characteristics rather than on the site of service. This system would lend itself well to a Medicare bundled payment strategy by aligning payments across settings for select conditions (MedPAC 2015).

As the longevity of Americans increases and the number of baby boomers reaching retirement grows, the demand for PAC and similar services will increase. These develop- ments offer strategic planning opportunities and business growth potential for a wide range of healthcare providers. Strategic Planning in Post-Acute Care.

Post-acute services also have the potential to significantly increase federal expenditures on the Medicare program. The Centers for Medicare & Medicaid Services (CMS) is concerned that a fragmented PAC system will increase costs and adversely affect the quality of care. To reduce expenditures and prevent fragmentation of services, CMS is considering bundling the payment for all PAC services that a Medicare patient receives after being dis- charged from an acute care hospital. Such a bundled payment would require IRFs, SNFs, adult health day care centers, and hospice facilities to work closely together to assume the risk associated with bundled Medicare payment for PAC. CMS views this bundling as a Post-acute care (PAC).

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EBSCO : eBook Collection (EBSCOhost) – printed on 4/18/2019 5:23 PM via WESTERN KENTUCKY UNIV AN: 1843079 ; Harrison. Strategic Planning in Post-Acute Care.