Outcomes in Stark Opposition to Recent NBER White Paper
A landmark outcomes study was publicly released today demonstrating that long-term care hospitals provide superior outcomes for the Nation’s most severely ill patients than in any other post-acute care setting.
The study, A Unified Post-Acute Care Reimbursement Model, Paying for Outcomes vs. Setting, Based on Acuity, was initially presented to a group of rehabilitation hospitals at last week’s 2018 American Medical Rehabilitation Providers Association Educational Conference and Expo in Boston by George Kyriacou, MSPH, President and CEO of Gaylord Hospital in Wallingford, CT. The research for the study was based on 2016 data from the Centers for Medicare & Medicaid (CMS).
“Post-acute care plays a significant role in our health care system,” Kyriacou explained. “In 2016, approximately 43% of Medicare beneficiaries who were discharged from an acute-care hospital went on to receive post-acute care from skilled nursing facilities, home health agencies, inpatient rehab facilities or long-term care hospitals.”
“But when we analyze the range of patient acuity – or the rating that is given to each patient based on the severity of their illness with a rating of “1” being the least ill and “4” being the most severely ill – found in each post-acute care setting, it is clear that long-term care hospitals disproportionately shoulder the care of the largest population of the highest severity of illness compared to any other post-acute care setting.”
“On average, 57.1% of all patients in a long-term acute care hospital in 2016 were considered by Medicare to be of the highest acuity,” he continued. “In comparison, only 15.8% of the nation’s skilled nursing facilities’ patient population was comprised of patients of the highest acuity.”
The data indicates that although long-term care hospitals care for an overall sicker population, such institutions provide significantly better outcomes for patients of the highest acuity with:
- Up to 15.4% fewer hospital readmissions
- Up to 30.6% longer time to readmission
- Up to 31.7% lower outpatient emergency room utilization rates
than patients of the same severity of illness recovering in other post-acute settings.
“The Medicare data demonstrates what LTCHs have known all along: our nation’s sickest patients achieve significantly better outcomes in long-term care hospitals than in any other post-acute care setting.”
The data and conclusions outlined in the study come in stark opposition to the conclusion of a National Bureau of Economic Research (NBER) working paper, Long-Term Care Hospitals, a Case Study in Waste released in August, 2018.
“Our findings do not align with the results of the NBER study which suggests that Medicare could realize $4.6 billion per year in savings with no harm done to patients by not allowing for discharge to LTCHs,” he continued.
“Clearly based on our research, LTCHs are important to a healthier, safer health care system and are an important resource for our nation’s sickest patients.”
“I, along with many of our Nation’s not-for-profit long-term care hospitals, hope that this research clearly demonstrates that patients of different acuity levels should be channeled to different settings in order to achieve the best outcomes at the very best cost,” he concluded.
About Gaylord Hospital:
Gaylord Hospital, headquartered in Wallingford, Connecticut, is a not-for profit, long-term 137-bed specialty hospital that provides care and treatment of people with complex medical and intensive rehabilitation issues. Gaylord also operates outpatient therapy centers in Wallingford, North Haven, and Cheshire. For latest news or more information go to their website at www.gaylord.org.
