CMS post-acute care project is move in the right direction

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A new pilot project from the Centers for Medicare & Medicaid Services looks promising from the perspective of post-acute care delivery.

The project, which CMS disclosed this week, will concentrate on a hospital patient’s transition from the acute-care facility to a long-term care facility, home or home healthcare.

The objective, according to CMS, not only is to help reduce unnecessary hospital readmissions but “to yield sustainable and replicable strategies that achieve high-value health care for Medicare beneficiaries.”

Here's a project that not only sounds worthwhile but necessary.

Post-acute care and the costs associated with it represent one of the most problematic aspects of the healthcare system. The haphazard shuttling of patients from one provider to another is just one reason our system gets the reputation it does.

It is often in the period after release from an acute-care setting that people fall through the cracks (sometimes literally falling) and then end up right back where they started—maybe in worse shape than before.

The statistics speak for themselves: Nearly one in five patients who leave the hospital today will be readmitted within the next month, according to CMS. More than three-quarters of these readmissions are potentially preventable.

Post-acute payment

Besides improving care delivery, this project is encouraging for another reason: It represents a step toward a new post-acute payment system. A new system would represent a solution to the ongoing problem of Medicare therapy caps, which place limits on the amount of therapy—speech, physical and occupational—a person may receive. An exceptions process has been in place, largely nullifying that for long-term care residents.

Several organizations, including the American Health Care Association, the Alliance for Quality Nursing Home Care, and the National Association for the Support of Long Term Care, have been working with CMS on this task.

A post-acute payment tool would be a part of this new system. There has been a lot of talk about this tool over the last few years. The tool would classify the patient appropriately and for the most appropriate setting.

Correctly diagnosing a patient and for the right setting? Now we're making progress.
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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.

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