How and how much Medicare pays for post acute care and where there is room for reform was the subject of the featured presentation at the Alliance’s annual meeting by Al Dobson of the Washington think tank Dobson/DaVanzo. The analysis was part of the Clinically Appropriate and Cost‐Effective Placement (CACEP) Project, which D/D has been engaged in on behalf of the Alliance for Home Health Quality and Innovation (AHHQI). According to Dobson, the data present a powerful case for rethinking the role of home health not only for patients leaving hospitals, but for deterring hospitalizations for patients residing in communities. “The home health community has recognized that it is more cost‐effective than facility‐based settings,” said Dobson, “but until now, has lacked the data analyses to support anecdotal evidence.”
One of the study’s findings is that of those patients referred for some form of post acute care, 38% are referred for home care; but these patients represent less than 30% of post acute payments. Dobson also presented data on the range of patient pathways following an acute stay suggesting that globally paid providers and bundled demonstrations are going to take a hard look at these with an eye toward both costs and outcomes and with a goal of simplification.
The CACEP study has now produced three working papers, all of which are on the AHHQI website, free of charge.