How LTACHs help health systems improve care and reduce cost

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Recent data shows 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 percent of the U.S. patient population, they account for 50 percent of healthcare spending, magnifying the need to properly identify the most efficient care delivery pathways for these patients.1 Further, COVID-19 patients have led to additional growth in both critically ill and medically complex populations.

Lack of access to the appropriate post-acute care setting for high-acuity patients often leads to discharge delays from STACHs. These delays can be detrimental for the patient and payers. Further, a transition to a lower-level of care such as a skilled nursing facility, that cannot provide physician-led acute care can lead to costly readmissions and an unfavorable patient experience. For these patients, treatment at an LTACH is often the most appropriate care setting for reducing avoidable delays in discharge and recovery.

Through this brief, you will learn four of the many distinctive benefits of LTACHs to 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. 

LTACHs are uniquely effective in treating medically complex patients — an already growing population that grew even more during the pandemic. Patients who benefit from LTACH care typically have spent three or more days in the ICU or require mechanical ventilation and have an average of nearly six comorbidities.2 Furthermore, despite the growing complexity of LTACH patients admitted in the past year, LTACHs were almost 50 percent less likely than SNFs to discharge a patient back to the hospital.3 An LTACH’s expertise in treating medically complex patients continues to play a valuable 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 critically ill patients who would benefit from continued acute care, as well as with payer networks to ensure these patients receive access to the most effective treatment for their diagnoses. Since LTACHs specialize in continued acute care and have 39 percent lower per-day payments than STACHs, they help contribute to an improvement in outcomes and in the overall cost efficiency of care delivery.As such, LTACHs are important partners in value-based networks and ACOs.

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 could include those with subspecialties such as pulmonology, infectious diseases, nephrology, or neurology, as well as care from a team of clinicians that is customized to their needs.

4. Comprehensive rehabilitation for lasting recovery

Along with intensive care unit treatment, LTACHs provide the rehabilitation care necessary for lasting patient recovery. The dangers of patient immobility are becoming clearer, including their link to rehospitalization rates. Studies show keeping patients in a bed or in a chair can increase the likelihood of muscle atrophy, blood clots and wounds.5 Furthermore, patients who spend extended time
in the ICU, including those recovering from COVID-19, are at a higher risk of developing post-intensive care syndrome, which can have a long-lasting impact on patient well-being.6 At an LTACH, medically complex patients receive comprehensive therapy in addition to continued critical care, which strengthens their muscles, increases cardiovascular and pulmonary endurance, and improves their cognitive communication skills and psychosocial well-being. This level of rehabilitation is made possible through interdisciplinary teams of respiratory therapists, physical therapists, occupational therapists and speech-language pathologists who have extensive training and are widely recognized for their ability to wean patients from ventilators.

In summary, these four clinical benefits lead to improved patient access and care quality, reduced readmissions, shortened length of stay 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 delivers value-enhancing services to partner hospitals through:

  • History of successful joint-venture partnerships and management agreements. Kindred partners with more than 300 of the leading hospitals across the country in many different service lines.
  • Best-in-class clinical quality. Kindred’s long history of treating high-acuity patients has allowed Kindred to achieve industry-leading clinical performance that exceeds national averages and peer groups in key indicators.

  • Longstanding LTACH-specific expertise. Kindred helped pioneer the long-term acute care hospital model three decades ago through developing the first hospitals in the nation specialized in pulmonary treatment and continues to lead the nation in caring for medically complex patients.

  • Lower costs/value-based modeling. Kindred brings unparalleled operational efficiency, optimization and has significant expertise in working with nationally-based health plans to ensure alignment with their goals to improve outcomes, reduce denials and lower overall cost of patient care.

  • The latest clinical innovation and technology. Kindred has a history of pursuing innovation with developments such as RehabTracker, Kindred’s proprietary patient engagement app and AfterCare, a Registered Nurse follow-up program.

To learn how your health system could benefit from an LTACH partnership with Kindred, visit KindredLTACHPartner.com.

References:

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
5. Ward, Lisa. The Wall Street Journal. “Hospitals Increasingly Tell Patients to Get Up and Move”, 2017
6. Ohtake PJ, Coffey Scott J, Hinman RS, et al. “Impairments, activity limitations and participation restrictions experienced in the first year following a critical illness: protocol for a systematic review.” BMJ Open;7:e013847. doi: 10.1136/bmjopen-2016-013847, 2017

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