Our Work

Long-Term Acute Care (LTAC) Hospitals as Part of the Value-Based Solution: A Case Study of LTAC Hospitals in Las Vegas

THE ISSUE

Long-term acute care (LTAC) hospitals specialize in providing treatment for patients with complex medical conditions who require intense and specialized treatment. Given their unique position as a more intensive care setting within the care continuum, LTAC hospitals have historically not served an active or sizable role within value-based care models, despite evidence of high clinical quality and patient experiences.

OUR WORK

Prior ATI Advisory research indicated that LTAC hospitals have provided strong clinical capabilities and have served as an essential safety net for the healthcare delivery systems during the COVID-19 Public Health Emergency. This analysis focused on the meaningful role that LTAC hospitals can play in value-based care through a case study of Kindred LTAC hospitals in the Las Vegas market.

With support from Kindred, ATI, in partnership with Cedar Gate Technologies, analyzed Medicare Fee-for-Service (FFS) claims to assess the experience of Kindred LTAC hospitals in Las Vegas across the entire Medicare FFS population as well as beneficiaries within an accountable care organization (ACO) located in Las Vegas. This analysis found that risk-adjusted Medicare spending in the 180 days after discharge from the initial post-acute care setting was 30-40 percent lower for ACO patients served by Kindred LTAC hospitals than those served by skilled nursing facilities in Las Vegas within the top volume conditions of sepsis and congestive heart failure. Furthermore, Medicare FFS beneficiaries who received care at Kindred LTAC hospitals had nearly 50 percent lower readmission spending after discharge from the initial LTAC hospital stay compared to other LTAC hospitals in Las Vegas.

This lower total post-discharge spending, especially among readmissions, is indicative of less disruption and reduced time in the acute care setting for patients, which contributes to increased patient satisfaction and a better care experience.

OUR VIEW

LTAC hospitals can provide great benefit, both financially and clinically, to payers and at-risk entities beyond the end of an acute care episode when patient’s needs are matched with the appropriate care setting. As demonstrated through this case study, LTAC hospital patients experienced fewer readmissions to the hospital, thus contributing to less disruption and lower total spending in the post-discharge period for this clinically complex patient population. Though additional analyses will illustrate the ability to generalize these findings to other markets and patient populations, these preliminary findings suggest that LTAC hospitals can meaningfully participate and contribute to success in value-based models by providing high-quality care for some of the most clinically complex cases.

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