The Pathway for Sustainable Growth Rate Reform Act of 2013 implemented a two-tier payment system for long term care hospitals (LTCHs). LTCHs that cared for patients with extended critical care during their referral hospital stay or who received prolonged mechanical ventilation within the LTCH are eligible for full payment under the LTCH Prospective Payment System. Patients not meeting these criteria would be reimbursed using “site-neutral” rates, which on average is less than 40% of LTCH PPS rates. KNG Health provided analytic support to develop effective responses for LTCHs to prepare for the effects of the new criteria. We provided analytics to get a better understanding each LTCH’s market area, including breakdowns on payment impacts, patients’ discharge status, and qualifying and non-qualifying cases. We also assessed LTCH’s quality measures relative to other LTCHs in the market and provided analytics on readmission patterns.
Services : Payment Policy & Delivery System Innovation Expertise: Medicare, Payment and Delivery System Innovation
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