Policy in Clinical Practice: Choosing Post-Acute Care in the New Decade
Policy in Clinical Practice: Choosing Post-Acute Care in the New Decade
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DOI：
10.12788/jhm.3577
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发表时间：
2021-03-01
影响因子：
2.6
通讯作者：
Grabowski, David C.
中科院分区：
文献类型：
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作者：
Makam, Anil N.;Grabowski, David C.
2018年，近一半的住院医疗保险患者出院后接受了急性期后护理（PAC），约占年度支出的600亿美元。有四个PAC设置，这些设置在提供的医疗，专业护理和康复服务的强度和复杂性方面有所不同;每个设置使用单独的支付系统。由于PAC的使用存在相当大的差异，担心类似的患者可以在不同的PAC环境中接受治疗，医疗保险和医疗补助服务中心（CMS）最近推出了几项重大政策变化。对于家庭保健机构（HHA）和专业护理机构（SNF），CMS实施了新的支付模式，以更好地将支付与患者的护理需求相结合，而不是提供康复服务。对于长期急性护理医院，CMS现在将减少对病情较轻患者的支付。为了明智地选择PAC，住院医生和医院领导必须了解这些新政策将如何改变患者可以出院的地方以及这些患者在这些PAC设置中获得的服务。(C)2021医院医学学会
Nearly half of hospitalized Medicare patients in 2018 were discharged to post-acute care (PAC), accounting for approximately $60 billion in annual spending. There are four PAC settings, and these vary in the intensity and complexity of medical, skilled nursing, and rehabilitative services provided; each setting uses a separate payment system. Due to considerable variation in PAC use, with concerns that similar patients can be treated in different PAC settings, the Centers for Medicare & Medicaid Services (CMS) recently introduced several major policy changes. For home health agencies (HHAs) and skilled nursing facilities (SNFs), CMS implemented new payment models to better align payment with patients' care needs rather than the provision of rehabilitation. For long-term acute care hospitals, CMS will now decrease payment for less medically ill patients. To choose PAC wisely, hospitalists and hospital leaders must understand how these new policies will change where patients can be discharged and the services these patients receive at these PAC settings. (C) 2021 Society of Hospital Medicine