Congress urged to address patient discharge bottlenecks through per diem payments

Patients are staying longer in hospital — often because there are inadequate resources to discharge them — and the solution may be Congress implementing a per diem Medicare payment to help unblock the bottleneck, the American Hospital Association said Dec. 6.

The average length of stay in hospitals has increased by approximately 19 percent for patients in 2022 compared to 2019, the AHA said, citing data from healthcare consulting group Strata Decision Technology. The increase is even more stark for patients discharged to post-acute care providers — a nearly 24 percent jump from 2019 to 2022.

Such delays affect both patient outcomes and the workforce in an already stretched healthcare system.

"Delays in patient discharges create bottlenecks in the healthcare system, adding to the already overwhelming challenges facing our hospitals and caregivers," AHA President and CEO Rick Pollack said in a statement.

One possible solution? Congress could establish temporary per diem payments targeting hospital systems and including acute, long-term care and rehabilitation facilities to help ease capacity issues. The payments would cover those patients ready to be discharged but who are unable to be, the AHA said.

The proposal from the AHA follows a letter written to congressional leaders Oct. 24 highlighting a number of issues where legislation could ease some of the current financial burdens facing the industry, including the idea of per diem payments.

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