The OIG said swing bed usage at critical access hospitals went up significantly from 2005 through 2010, and the average Medicare spending for swing bed services at these hospitals steadily increased to almost four times the cost of similar services at alternative facilities.
Out of 100 critical access hospitals sampled by the OIG, 90 had alternative facilities within a 35-mile radius with alternative skilled nursing care available, according to the report.
Based on sample results, it is estimated that swing bed services provided at 90 percent of the critical access hospitals in the OIG’s 1,200-hospital sampling frame could have been provided at alternative facilities within 35 miles of the critical access hospitals during calendar year 2010, according to the report.
Overall, the OIG estimated that Medicare could have saved $4.1 billion over a 6-year period if payments for swing bed services at critical access hospitals were made using skilled nursing facility prospective payment system rates.
Therefore, the OIG recommended that CMS seek legislation to adjust swing bed reimbursement rates for critical access hospitals to the lower rates paid for similar services at alternative facilities.
CMS agreed with the OIG findings related to the increase in critical access hospitals’ swing bed utilization but disagreed with the OIG’s recommendation due to concerns with the OIG’s findings on the availability of skilled nursing services at nearby alternative facilities and its calculation of savings, according to the report.
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