Addressing Medically Complex Patient Challenges: How LTACHs Help Health Systems Improve Care and Reduce Cost

Recent data shows that patients admitted to short-term acute care hospitals (STACHs) have increasingly complicated medical conditions. This has led many hospitals to seek support from experienced management partners in the long-term acute care hospital (LTACH) space to help address the unique needs of this critical population. While medically complex and critically ill patients make up only 5% of the U.S. patient population, they account for 50% of healthcare spending.1

Lack of access for high-acuity patients in the post-acute care setting often leads to discharge delays from STACHs. These delays can be detrimental for the patient and payors. Treatment at an LTACH is often the most appropriate care setting for reducing avoidable delays in discharge and recovery.

Read this guide to discover four benefits LTACHs have on the sickest and most vulnerable patient population. You will also learn how adding LTACH services to your health system’s care continuum or working with a management partner to optimize your current service can help reduce avoidable days, lower total cost of care and improve outcomes for the system overall.

1. Experience Treating a Growing Medically Complex Patient Population

Patients who benefit from long-term acute care typically have had three or more days in the ICU or require mechanical ventilation. On average, LTACH patients have nearly six comorbidities and the Case Mix Index (CMI) and Average Length of Stay (ALOS) at these facilities has increased in the past year.2,3 Throughout this time, LTACHs further demonstrated their specific advantage among post-acute care providers in treating this medically complex patient population, as evidenced by the fact that LTACHs were 50% less likely than SNFs to discharge a current patient to a STACH.3 This expertise in treating medically complex patients plays a critical role in reducing costly readmissions.

2. Cost Efficiency and Population Health Management

As part of their commitment to patient recovery, LTACHs work with families and healthcare providers to identify patients who would benefit from continued acute care, as well as with payor networks to ensure that these patients receive access to the most effective treatment for their diagnoses. This involvement contributes to an improvement in patient outcomes and in the overall cost efficiency of care delivery. LTACHs have 39% lower per-day payments than STACHs. As such, LTACHs play a critical role in value-based networks and accountable care organizations.4

3. Setting and Physician Staffing Designed for Highly Acute Patients

LTACHs are licensed as acute care hospitals and are accredited by The Joint Commission. Patients at LTACHs benefit from onsite telemetry, diagnostic imaging and lab capabilities that reduce the need for outpatient services. They also receive 24/7 oversight from physicians, which often include those with subspecialties such as pulmonology, infectious diseases, nephrology or neurology, as well as care from a team of clinicians customized to their needs.

4. Comprehensive Rehabilitation for Lasting Recovery

Along with ICU-level treatment, LTACHs provide the rehabilitation care necessary for lasting patient recovery. LTACHs have the clinical expertise to successfully support recovery for patients who require extended ICU-level treatment. Patients receive comprehensive therapy that strengthens their muscles, increases cardiovascular and pulmonary endurance, and improves their cognitive communication skills and psychosocial well-being.

Further, patients recovering in an LTACH receive rehabilitation from a robust interdisciplinary team who have extensive training and are widely recognized for their ability to wean patients from ventilators.

These four clinical benefits lead to improved patient access and care quality, reduced readmissions, shortened LOS and ultimately lower total costs for the health system.

While the benefits of having LTACHs within the health system’s care continuum are clear, developing and running a fully optimized LTACH can be challenging because of the complex patient population and highly regulated space. Partnership with an experienced LTACH operator can help ease the burden while still providing the many benefits to patients and the health system.

Kindred Healthcare: Recognized Expert in Specialty Hospital Care and Partnership

Kindred Healthcare partners with health systems to develop new or optimize existing LTACHs through hospital-within-a-hospital (HIH), contract management and joint-venture freestanding partnership opportunities. For more than 30 years, Kindred has worked with patients and health systems across the country to improve outcomes, reduce readmissions and help patients transition to home or a lower level of care.

Kindred delivers value-enhancing services to partner hospitals through:

  • History of successful joint-venture partnerships and management agreements
  • Best-in-class clinical quality
  • Longstanding LTACH-specific expertise
  • Lower costs/value-based modeling
  • The latest clinical innovations and technology

For information about how your health system could benefit from an LTACH partnership with Kindred, visit



  1. 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
  2. Kahn, Jeremy M et al. “Long-term acute care hospital utilization after critical illness.” JAMA vol. 303,22: 2253-9. doi:10.1001/jama.2010.761, 2010
  3. ATI Advisory. “Role of LTAC Hospitals in COVID-19 Pandemic”, 2021
  4. Kindred Healthcare calculations using data from CMS MEDPAR, 2019

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