Large Increases In Spending On Postacute Care In Medicare Point To The Potential For Cost Savings In These Settings

Identifying policies that will cut or constrain US health care spending and spending growth dominates reform efforts, yet little is known about whether the drivers of spending levels and of spending growth are the same. Policies that produce a one-time reduction in the level of spending, for example...

Full description

Saved in:
Bibliographic Details
Published in:Health Affairs 2013-05, Vol.32 (5), p.864-872
Main Authors: Chandra, Amitabh, Dalton, Maurice A., Holmes, Jonathan
Format: Article
Language:English
Subjects:
Beneficiaries
Comorbidity
Cost analysis
Cost control
Cost reduction
Disease
Enrollments
Fractures
Government programs
Health care
Health care expenditures
Health care policy
Heart attacks
Heart failure
Hip joint
Hospitalization
Hospitals
Medicare
Mortality
Patients
Per capita
Rehabilitation
Reimbursement
Studies
Subacute care
Trends
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Identifying policies that will cut or constrain US health care spending and spending growth dominates reform efforts, yet little is known about whether the drivers of spending levels and of spending growth are the same. Policies that produce a one-time reduction in the level of spending, for example by making hospitals more efficient, may do little to reduce subsequent annual spending growth. To identify factors causing health care spending to grow the fastest, we focused on three conditions in the Medicare population: heart attacks, congestive heart failure, and hip fractures. We found that spending on postacute care-long-term hospital care, rehabilitation care, and skilled nursing facility care-was the fastest growing major spending category and accounted for a large portion of spending growth in 1994-2009. During that period average spending for postacute care doubled for patients with hip fractures, more than doubled for those with congestive heart failure, and more than tripled for those with heart attacks. We conclude that policies aimed at controlling acute care spending, such as bundled payments for short-term hospital spending and physician services, are likely to be more effective if they include postacute care, as is currently being tested under Medicare's Bundled Payment for Care Improvement Initiative. [PUBLICATION ABSTRACT]
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2012.1262