Avalere Health - McKnight's Long Term Care News

Avalere Health

Brian Fuller

Positioning for narrowing PAC networks

Variation and growth in post-acute care spending has earned PAC a spot on hospital and health systems’ priority list for cost-saving opportunities. The success of new care delivery models — particularly hospital-driven bundles and accountable care organizations — also is dependent on reduced utilization and episodic cost management in non-hospital settings.

Jeff Terkowitz

New payment models present opportunities for SNFs

For skilled nursing facilities, the Medicare SNF 3-day rule can make it difficult to place the right patients in the right setting at the right time. The 3-day rule requires that a Medicare beneficiary spend three nights in a hospital as an inpatient — observation stays do not count — before becoming eligible for Medicare-covered SNF care. This rule creates a challenge for SNFs as hospital lengths of stay decline for many of the conditions that SNFs treat.

Anne Tumlinson

Keeping score in 2014

If new payment reform initiatives sowed the seeds of small disruptions in 2013 — narrowing referral networks and prompting clinical integration, those seeds will start sprouting bigger disruption across multiple markets in 2014. This year ACOs will proliferate and will include SNFs in a real way. Bundled payment experiments will be beginning all over the country.

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