Editor's note: This article has been updated to correct a quote by William Walters.
For fiscal 2008, the Medicare margin for long-term acute-care hospitals is expected to be between negative 1.4% and negative 0.4%, according to a presentation from the executive director of the Medicare Payment Advisory Commission at a meeting of post-acute providers this week.
Mark Miller, executive director of MedPAC, gave the report on LTAC hospitals at the Acute Long Term Hospital Associations fall conference in Crystal City, Va. His report also showed the number of LTAC hospitals grew 7% between 2000 and 2006, but growth was flat from 2006 to 2007. Meanwhile, the number of beneficiaries using LTAC hospitals fell 2.5% between 2005 and 2006.
In discussions and sessions at the conference, attendees talked about the need for patient and certification criteria. Long-term-care providers for years have emphasized the need for these criteria to ensure that patients who require long-term acute caretypically defined as a hospital stay of 25 days or moreare placed in the most appropriate setting. Now two long-time rival associations in the post-acute segment have come together to pursue this topic. William Walters, chief executive officer at ALTHA, said the association and the National Association of Long-Term Hospitals have joined forces in an effort to sell their message about the importance of LTAC hospitals to leaders on Capitol Hill.
We are trying to avoid what Sigmund Freud called, the narcissism of small differences, Walters said of the partnership. Edward Kalman, general counsel for NALTH, was not at the ALTHA meeting, but said in an e-mail message that the group hopes the process will secure and stabilize Medicare beneficiary access to the programs of care needed by medically complex patients. The American Hospital Association and Federation of American Hospitals will serve in an advisory capacity, according to Kalman.
The topic of a uniform assessment tool for these facilities was also the feature of a presentation led by Barbara Gage, director of post-acute research at RTI International in Waltham, Mass. Gage also directs CMS current Medicare Post Acute Care Payment Reform Demonstration, which studies patient characteristics, resource costs, and outcomes for treating the elderly and disabled Medicare populations discharged from the hospital to post-acute settings. The demonstration went live in March, Gage said, and it will cover 10 markets and 175 providers in post-acute settings nationwide.
Barbara Gages projects indicate that Congress and CMS believe some type of tool of standardized care is important, said Dexanne Clohan, senior vice president and chief medical officer at HealthSouth Corp. in Birmingham, Ala. Clohan, a conference attendee, was named recently as one of Modern Healthcare's 50 Most Powerful Physician Executives In Healthcare. Jessica Zigmond
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