3.1.2: Post-Acute Care: Spending

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Do curso por University of Minnesota

Healthcare Delivery Providers

116 ratings

University of Minnesota

Healthcare Delivery Providers

116 ratings

Curso 2 de 5 em Specialization Healthcare Marketplace

Welcome to the exciting world of Healthcare Delivery Providers! This second course in the Healthcare Marketplace Specialization will help you understand the various providers of healthcare across the U.S. delivery continuum. We will explore the unique value proposition of the various providers- from hospitals and clinics to physicians to community based providers. We will dissect this important value chain using various lenses such as- site of care delivery, people who provide the care and payers who pay for care. You will also learn about the challenges facing these providers and the innovations they are creating in order to help transform this important industry. I will use readings such as a case study and videos to make this learning more experiential for you, so that you can see and feel the world of healthcare delivery. I will also explain the various acronyms and specialized terms used in healthcare, so that you become more proficient and familiar with the language. Given the fact that Healthcare is one of the largest industries in the U.S. and growing at an rapid pace, it is critical that current and future leaders understand the internal and external drivers that are shaping this industry. Current and future leaders will need to constantly innovate in order to sustain this industry into the future- by creating value for the end customer and the entire population, as well as increasing engagement of the humans who work within this industry. Get ready to take a deep dive into the complex ocean that is U.S. healthcare delivery- and make sure your oxygen tank is securely fastened!

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POST-ACUTE CARE & COMMUNITY-BASED SERVICES

In this module I will review post-acute care with you, i.e. care for patient after discharge from the acute care in the hospital. We will discuss the various post acute care providers and how they are organized. We will also examine how post acute care providers are measured, what challenges they face and what innovations they are leading.

3.1.1 Post-Acute Care: Sites of Care Delivery9:49

3.1.2: Post-Acute Care: Spending4:37

3.1.3 Post-Acute Care: Trajectories and Configurations9:49

Conheça os instrutores

Dr. Rahul Koranne
Faculty
Carlson School of Management, Department of Finance

This is the Healthcare Delivery Providers,

part of the Healthcare Marketplace Specialization.

Module 3.1.2, Overview of Post Acute Care: Spending.

Lecture we will look at the difference between post-acute care and

long-term care.

We'll look at who pays for post-acute care and

then finally discuss some trends in post-acute care spending.

So here's a familiar post acute care blown up road map.

And this particular lecture is kind of critical because it talks about

how post acute care is paid and you will appreciate in the next

few minutes how complicated the payment systems are for post acute care.

Many different models.

There is a push, however, right now to start aligning some of these models and

looking at a patient's flow across the post acute care service chain.

So again, if your head starts spinning as we go into some of these details,

just take a deep breath, take a pause, come back to it and I'll dig into some

of these more in detail in the next few lectures, but let's get started.

So first start with what's the difference between post acute care and

long term care.

The main difference is post acute care and medical interventions, like LTACH, IRF,

SNF, home healthcare that we will discuss to help recover from medical illnesses.

And long-term care is more social components needed for

personal care and routine daily needs like activities of daily living, bathing,

or instrumental activities of daily living like telephone, groceries, housework.

Over here, Medicare is the primary payer but also Medicaid.

And for social long term care, Medicaid is the primary payer.

This graph from MedPAC shows that Medicare is the largest

purchaser of personal healthcare at 22%, the biggest private

health insurance companies at 34% and Medicaid at 17%.

This graphs shows the different payers that pay for home health care.

So it's mostly Medicare but a little bit of Medicaid, actually quite a bit.

And then for nursing home care,

it's quite a bit Medicaid and a little bit of Medicare.

And then you can see the other components of the delivery system as well.

Let's do a quiz.

This graph also from MedPAC is very interesting,

looking at Medicare spending for the last decade or

so and as you can see, for post-acute care, there's a rapid increase.

Actually, there's also a rapid increase for hospital and

physicians and outpatient hospitals.

So basically all of the spending is increasing, including post-acute.

This is the Medicaid expenditures in home and community based services.

Again, post acute care, same trend here, rapid growth in the last decade.

Graphs from MediPac are show that the Medicare spending is concentrated

post acute care and other sectors.

SNF has remained the same, and note the numbers spent over the last decade.

Home health care has remained the same.

Hospice is growing from 2 to 3%.

This is an important graph as well, looking at Medicare spending.

And the most costly 1% of beneficiaries drive 15% of the spending.

And the next costly 4% drive 24%, so between this 5% of costly folks,

that accounts for about 40% of the total M edicare spending.

So, again, this is what we call hot spots, and

if you know who these patients are like Harlan Reeves, you can focus on them and

throw some resources to try to improve their care and lower their cost.

So, in summary, post-acute care is very different than long-term care.

A very small number of patients, 5%, drive a majority of the costs, so, 40%.

Wow, that's something to remember.

Think Harlan Reeves again.

And then, there is increasing post-acute care spending by all payers,

Medicare, Medicaid and other.

So, that's something very important for us to remember.

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