... Developments in Medicare Affecting Long-Term Care Hospitals Sibyl Tilson Specialist in Social Legislation... Domestic Social Policy Division Summary Medicare pays about $36 billion annually for post-acute care...), skilled nursing facilities (SNFs), and in the home. Medicare pays for care in each setting under a unique... PAI. Generally, Medicare requires that LTCHs be licensed as acute care hospitals and have an average... length of stay of 25 days. Although there is no prior hospitalization requirement in order for a Medicare
Recent Developments in Medicare Affecting Long-Term Care Hospitals: Searching Inside
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... CRS-6 Moreover, according to CMS, Medicare margins were at 8.8% in 2003 (the first year of LTCH... PPS (from FY1996 through FY2002), Medicare margins ranged from between a minimum of -2.2% in FY2002... payment rates in order to recommend an update for the upcoming year. MedPAC found that Medicare payments... as indirectly established by the 13% annual increase in Medicare beneficiaries who use an LTCH each year from... to 200421; " Increased provision of Medicare services as measured by the 12% annual increase in services
... CRS-2 to rate year (RY) 2007 Medicare payments have attracted attention. Also, past actions from... the Centers for Medicare and Medicaid Services (CMS) regarding requirements imposed on LTCHs... and their advocates. Identifying Appropriate Post-Acute Care Settings The Medicare, Medicaid, and SCHIP Benefits... status of Medicare patients who receive hospital, rehabilitation, SNF, home health, therapy, or other... and to discuss the status of and solicit recommendations on Medicare's current post-acute payment systems
... on the date of discharge from an acute care hospital (paid under Medicare's inpatient prospective payment... than six months after the end of the program. DRA authorized the transfer of $6 million from Medicare... of an LTCH operating as part of another provider.8 Although the Medicare statute does explicitly address... be established to function as independent LTCHs.10 As established in the final rule, Medicare will continue... found that 29% of 1,400 randomly selected LTCH Medicare admissions in 2004 did not need LTCH
...-Setting Methods Other issues have been raised about changes that have been proposed for the RY2007 Medicare LTCH... of total Medicare discharges for like hospitals in the metropolitan statistical area (MSA). Patients... hospital referrals. 12 FY2004 and FY2005 Medicare data indicate that the 63.7% of the 201 freestanding... LTCHs receive at least 25% of their Medicare discharges from a single IPPS hospital; 23.9% of those... LTCHs receive 75% or more of their Medicare discharges from one IPPS hospital - 71 Federal Register 4698
..., an inappropriate admission to the LTCH, and a second, unnecessary Medicare payment to the LTCH.16 Among other... in the number of LTCHs,17 growth in Medicare payments per discharge relative to costs per discharge,18... of greater than 20 days, and demonstrate that 80% or more of its annual Medicare inpatient discharges
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