Patients discharged to home care have higher rates of hospital readmissions
A Penn study highlights important tradeoffs between home versus nursing facilities as the cost for post-acute care rises and payment models shift.
Spending on post-acute care continues to rise in the United States. Today, nearly 90 percent of Medicare patients discharged to post-acute care receive that care in either a skilled nursing facility or home health care. However, little is known about the differences in outcomes and costs between these two settings. Now, a new study shows that Medicare patients discharged from the hospital and into home health care have higher rates of hospital readmissions compared to those discharged to a skilled nursing facility. The results, published in JAMA Internal Medicine, also show that providers received significantly lower Medicare payments for these patients.
“With the increasing costs of post-acute care and changing payment models that hold providers more accountable for costs across clinical settings, it’s important to assess and understand the impacts of these choices,” says first author Rachel Werner,a professor of medicine and director of Health Policy and Outcomes Research at the Perelman School of Medicine. “We found clear tradeoffs: While home health care may cost less, it doesn’t have the same intensity of care as a skilled nursing facility, which may be sending many of them back into the hospital.”
The findings have important implications for today’s health care system, which continues to work toward refining payment incentives that optimize provider response and reduced spending. In 2015, Medicare spent more than $60 billion on post-acute care, a figure that has continued to rapidly increase.
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