Researchers Say Long-Term Care Hospitals Structure Discharges to Get Maximum Payments

Researchers Say Long-Term Care Hospitals Structure Discharges to Get Maximum Payments

In what authors call a “distortion” of a Medicare prospective payment system (PPS) adopted 12 years ago, a new study says that long-term care hospitals (LTCHs) are basing discharge decisions less on patient status and more on capitalizing on a schedule that maximizes their reimbursements.

For their study, researchers looked at LTCH discharges for 55,840 patients 65 and older who were admitted for a respiratory symptom diagnosis that required prolonged ventilation—a sample that authors write “is persistently the most common and highest-reimbursed [diagnosis related group].” Authors reviewed records from 444 LTCHs of varying sizes across the country, looking to see if they could discern a pattern of discharges clustered around day 29, the end of the “short stay threshold,” after which reimbursements peak for this particular diagnosis group.

What they found didn’t really require much discernment.

Full story of long-term care and discharge payments at APTA

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