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Studies: Hospital stays contribute to high Medicare long-term care costs

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Surveyors will be checking to see how well hospital discharge procedures facilitate SNF transfers
Surveyors will be checking to see how well hospital discharge procedures facilitate SNF transfers

Healthcare delivery system reforms could help reduce some of the "excessive and preventable" Medicare costs incurred by beneficiaries who live in long-term care facilities, according to recent reports from the Kaiser Family Foundation.

During 2006, roughly 1.7 million Medicare beneficiaries lived in long-term care facilities. As a result of high rates of hospitalization, emergency room visits and skilled nursing care, this group of Medicare beneficiaries cost the seniors' health program $25 billion, or 9% of total Medicare spending, according to Kaiser. Up to 40% of those costs stem from trips to the hospital. These residents "account for an excessive and preventable portion of Medicare spending," according to Kaiser Health News.

Many physicians reportedly prefer treating these patients in a hospital setting because all the diagnostic tools are readily available, and they can treat multiple patients at once, the Kaiser reports found. Similarly, nurses prefer the inpatient setting to the residential setting for fear of missing potentially life-threatening conditions.

Between 30% and 67% of these hospitalizations could be prevented with “well-targeted interventions,” according to the Kaiser report. Better coordination of care could also reduce the number of hospitalizations. Even a 25% reduction in these trips to the emergency room could net $2.1 billion in savings in 2010 alone, the reports find. These savings could in turn produce savings to Medicaid, which funds roughly 60% of all nursing home care, according to Kaiser.

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