Medically complex and critically ill patients now makes up 10% of the overall Medicare population, translating into four million individuals around the nation. This rapidly growing population continues to consume a disproportionate amount of acute healthcare resources and has a significantly higher-than-average likelihood of hospital admissions and readmissions.
These individuals experiencing chronic illnesses require intensive and specialized care within a facility equipped to meet their needs. Long-term acute care hospitals (LTACHs) have demonstrated favorable outcomes in treating anddischarging these high-acuity patients back home or to a lower level of care.
Read this brief to discover four key benefits of LTACH integration on a health system’s care continuum.
How long-term acute care within a hospital helps generate superior outcomes
Whether a health system constructs a freestanding LTACH or incorporates a hospital-in-hospital (HiH) structure, medically complex patients can receive the specialized care they need. Through an HiH, a hospital can offer specialty services within the system’s continuum of care, opening the door to more high-quality programs that will positively impact the facility and community. The HiH structure, combining multiple levels of medical, rehabilitative and psychological services tied to a single system, also supports continuity of physician and specialist oversight of patient care.
In order to strengthen the long-term acute care offering, health systems are looking for an experienced partner who is well equipped to handle the complexities and sensitivities found in this population.
Four key benefits of LTACH partnership include:
1. Lowered Short-Term Acute Care Length of Stay
Integration of an LTACH through a strategic partnership enables a hospital to identify patients best suited for long-term acute care. This ultimately reduces unnecessary treatment in another setting and provides the high-quality, specialized care needed to reduce rehospitalization risk and improve patient satisfaction and outcomes within the health system as a whole.
A specialized LTACH partner will be able to identify qualified LTACH patients earlier. This is done by:
- Engaging and coordinating with executive sponsor physicians and care managers.
- Identifying and transferring LTACH-appropriate patients with the help of designated clinical liaisons.
- Monitoring results through weekly performance repor reviews with a hospital’s care management team.
As a result, an LTACH partner can produce outcomes that decrease average length of stay (ALOS) and improve patient outcomes and financial performance for short-term acute care hospitals (STACHs).
2. Decreased Readmissions to Acute Care Hospitals
Appropriate utilization of an LTACH’s resources for treating critically ill patients helps to significantly reduce the risk of readmission compared to other post-acute settings. Having a partner with a robust team of national recruiters who can help identify qualified, engaged and devoted candidates can improve patient outcomes and help produce greater access to resources and specialized expertise.
Specific clinical positions that can play a critical role in treating medically complex patients include:
- Speech-Language Pathologists (SLP): Since many patients have tracheostomies and/or are ventilator-dependent while receiving care in an LTACH, the SLP’s role is vital in helping patients work on swallowing abilities, tolerance for voice prostheses and communication skills.2
- Pulmonologists: LTACHs are in a unique position to care for complex pulmonary patients because of their ability to provide acute-level care, with a particular competency for those with pulmonary issues. Many pulmonary patients have multiple comorbidities and would benefit from seeing a physician every day, something LTACHs offer.
The superior training, education and programming supplied by a qualified LTACH partner can generate a unified interdisciplinary team approach – leading to reduced readmission risk and care costs.
3. Reduced Care Costs
While medically complex patients make up only a small percentage of the U.S. patient population, they account for 50% of healthcare spending.3 It’s vital to have an experienced partner that can help ensure a hospital is strategically utilizing resources. The utilization of highly-trained staff and medical directors, implementation of technology and obtaining Joint Commission accreditations and special certifications can aid in achieving lower care costs, therefore benefiting patient outcomes and hospital efficiencies.
Through the HiH LTACH partnership model, facilities can experience 39% lower per-day payments compared to STACHs, while also mitigating exposure to costly outlier payments to STACHs – further demonstrating an LTACH partner’s critical role in value-based networks and accountable care organizations.4 Through these tools and strategies, a qualified LTACH partner can help offer a hospital significant potential for savings and quality improvements.
4. Improved Quality and Patient Satisfaction
LTACH integration through the guidance of an experienced partner can provide high-risk patients specialized care throughout their entire recovery. Additionally, having a qualified partner that is equipped with the expertise and resources to reduce ALOS, lower the risk of readmission and reduce care costs will enhance the overall performance of a hospital and generate long-term positive outcomes for patients and the community it serves.
Treating the growing medically complex patient population is an urgent need for health systems across the country. Being able to rely on a trusted expert in the long-term acute care space can help relieve the burden of successfully addressing this patient population.
Benefits of Kindred LTACH Partnership
By reevaluating your system’s current offerings, your hospital may be able to identify opportunities to adjust services or optimize programs to better meet patient needs. A contract management or joint-venture LTACH partnership can do just that by helping to identify areas where HiH LTACH integration could substantially benefit your hospital. ■
References
1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360(14):1418-1428.
2. ASHA (Ed.). Long-term Acute Care Hospitals. https://www.asha. org/slp/healthcare/ltac/.
3. Kaiser Family Foundation calculations using data from U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS), Household Component, 2010.
4. Kindred Healthcare calculations using data from CMS MEDPAR, 2019