Subacute Care
A
recent Wall Street Journal article raised questions about the regulatory
future and possible ethical problems of hospital-integrated subacute care
facilities. However, it failed to raise some equally important questions.
What is the effect of integrated subacute care on quality and outcomes?
And what is the competitive future of under utilized acute-care facilities
without this important source of revenue? We don't pretend to know all
the answers to these questions, but we can help you answer the fundamental
question of whether or not a subacute care facility makes sense for your
institution.
We believe that
in many cases, both the patients and the hospital can benefit from the
integration of a subacute care facility. We are advising our clients to
analyze the outcome improvements and revenue enhancement potentials of
opening an integrated subacute care facility. The viability of such a venture
will depend in large part upon the population served as determined by your
case mix, current length of stay and utilization. In the case of some of
our clients, we discovered that up to 41% of patient days in Medicare cases
with lengths of stay between five and 14 days, could have been treated
in a subacute setting.
If you are facing
strategic decisions about subacute care, we can get you the facts you need
to make the right choice. Typically, we would approach this question with
the following methods:
- Conduct a two-year historical case mix analysis
- Benchmark your facility's length of stay performance and outcomes against comparable facilities in high-volume and/or high-cost DRGs
- Review medical records to determine
- The level of potential subacute care patients
- The critical issues affecting length of stay and resource utilization
- The accuracy of the coding and DRG assignment
- Conduct a concurrent review of inpatients
- Interview utilization and/or case management staff
- Identify medical staff issues
- Review state regulatory trends
- Identify reimbursement issues and opportunities
- Identify and study regional competition for subacute care services
- Prepare final written management plan
- Financial analysis
- Business plan
- Create implementation plan
With the rapid growth
of alternative care settings and the increased pressure to reduce inpatient
stays, the need for hospitals to compete for subacute care is clear. If
this nation's hospitals are to continue to provide advanced, high-quality
acute care at a reasonable cost, some cost may have to be borne by the
use of subacute care. We believe that demographic and financial pressures
will continue to drive this issue for the foreseeable future.
Please feel free to call us for further discussions.
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