Addressing Population Health Care Transitions by Utilizing Swing Bed Post-Acute Care

2021 ◽  
Vol 22 (3) ◽  
pp. B11
Author(s):  
Erika Leung ◽  
E. Leung ◽  
H. Parker
Keyword(s):  
Health Care ◽  
Population Health ◽  
Acute Care ◽  
Care Transitions ◽  
Health Care Transitions ◽  
Post Acute Care

Abstract WP356: Unbundling Care Transitions and Cost After Stroke: Results From the BPCI-Advanced Program

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Geri Sanfillippo ◽  
Brian Olkowski ◽  
Hermann Christian Schumacher ◽  
David Dafilou ◽  
Colleen Bowski ◽  
...  
Keyword(s):  
Acute Care ◽  
Resource Utilization ◽  
Care Coordination ◽  
Program Implementation ◽  
Care Transitions ◽  
Inpatient Rehabilitation ◽  
Hospital Length Of Stay ◽  
Early Supported Discharge ◽  
The Impact ◽  
Post Acute Care

Introduction: The Centers for Medicare and Medicaid Services bundled payment for care improvement advanced (BPCI-A) program incentivizes providers to better coordinate care, reduce expenses, and improve quality. The purpose of this study was to determine the impact of improving post-acute care coordination after stroke on quality and resource utilization in the BPCI-A program. Methods: Capital Health collaborated with post-acute providers to improve communication, identify criteria for early supported discharge to the community, expedite home health and outpatient services, reduce readmissions, and initiate advanced care planning. The redesigned post-acute care coordination program was implemented at Capital Health’s primary and comprehensive stroke center. Quality outcomes and resource utilization measures for patients enrolled in the BCPI-A program were compared to BPCI-A eligible patients prior to program implementation. Results: Forty-three patients enrolled in the BCPI-A program were compared to 77 patients eligible for enrollment. Clinical and demographic characteristics were similar (p>.05). After program implementation, 21.5% fewer patients were discharged to an inpatient rehabilitation facility (p=.024) and 14% more patients were discharged to inpatient hospice (p<.001). On average, post-acute cost decreased $16,608 per patient (p=.007) resulting in a $16,820 reduction in the 90-day cost per episode (p=.011). The 90-day hospital readmission rate decreased insignificantly by 14.1% from 23.4% to 9.3% (p=.056). Hospital cost, hospital length of stay and the 90-day mortality rate were unchanged (p>.05). Conclusion: The coordination of post-acute services facilitates care transitions after stroke. The identification of patients meeting criteria for early supported discharge to the community or admission to inpatient hospice helped reduce post-acute cost without increasing 90-day readmission or mortality.

scholarly journals Racial Differences in Health Care Transitions and Hospice Use at the End of Life

2019 ◽  
Vol 22 (6) ◽  
pp. 619-627 ◽  
Author(s):  
Shi-Yi Wang ◽  
Sylvia H. Hsu ◽  
Melissa D. Aldridge ◽  
Emily Cherlin ◽  
Elizabeth Bradley
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Racial Differences ◽  
Care Transitions ◽  
Hospice Use ◽  
Health Care Transitions

Costs and Resource Utilization in Prolonged Critical Illness

2014 ◽  
Author(s):  
Christopher E Cox
Keyword(s):  
Health Care ◽  
Critical Illness ◽  
Acute Care ◽  
Patient Population ◽  
Health Care Policy ◽  
Patient Flow ◽  
Prolonged Mechanical Ventilation ◽  
Post Discharge ◽  
Chronic Critical Illness ◽  
Post Acute Care

Patients who have chronic critical illness, operationally defined as those requiring prolonged mechanical ventilation, are markedly increasing in number and commonly experience profound, persistent physical and psychological debilitation. This patient population consumes an extraordinary amount of health care resources attributed to both the acute hospitalization as well as complex post-discharge treatments provided across multiple post-acute care facilities. Currently, the US health care system incentivizes these patient flow dynamics. Health care policy changes addressing post-acute care payment are inevitable. This chapter highlights potential patient, family, physician, and systems targets for current and future interventions, designed to improve quality and reduce costs for this patient population.

Use of Nonpalliative Medications Following Burdensome Health Care Transitions in Hospice Patients

Medical Care ◽  
2019 ◽  
Vol 57 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Patrick M. Zueger ◽  
Holly M. Holmes ◽  
Dima M. Qato ◽  
A. Simon Pickard ◽  
Gregory S. Calip ◽  
...  
Keyword(s):  
Health Care ◽  
Care Transitions ◽  
Hospice Patients ◽  
Health Care Transitions
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