In a November 2013 report for the National Association of Long Term Hospitals, KNG Health developed a policy proposal to improve the value of LTCHs to Medicare and its beneficiaries. This project included an empirical examination of the effects of receiving care in an LTCH as compared to receiving care in some other setting and the development of patient-level criteria and associated payment policies. The results presented in the paper offered a path forward for reforming Medicare regulatory and payment policies for LTCHs. We proposed criteria for appropriate selection of LTCH patients and a structure for LTCH payment reforms to ensure continued access to LTCHs for those patients who may benefit the most from this level of care, while tying growth in LTCHs to the growth in the number of chronically critically ill and medically complex (CCI/MC) patients. We modeled the impact of our proposed criteria and payment reforms. We estimate baseline payments in 2014 to be $5.53 billion with $3.77 billion for CCI/MC cases and $1.76 billion for non-CCI/MC cases. Under our proposed policy, payments for non-CCI/MC cases would fall by $890 million or approximately 16 percent of total LTCH payments under current law.
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Services: Payment Policy & Delivery System Innovation
Services : Payment Policy & Delivery System Innovation Expertise: Medicare, Payment and Delivery System Innovation
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