Disparity in information regarding post-acute care

However, the MedPAC expresses concern that how this should be done has remained a problem.

A post-acute care facility is a home or a specialized institution that support an individual to see that they continue to recover well from an illness or an injury.

David Nerenz, PhD, of Henry Ford Health System in Detroit says that in the hospital world, there exist thousands of value measures. David adds that skilled nursing amenities are simpler, save for one would still have hundreds of measures to consider including every star rating system takes a separation of those.

The second point is that is that the procedures are not. The second key thing is that the measures are not connected among another, hence any division you take you take will not have an extrapolative influence for in what manner the outcomes will play out.

However, if you have enrolled in a post-acute care facility, it is noble not to be misguided by the so called star rating of the facilities.

This pertinent issue emerged when members of the commission were discussing ways on how to advise patients and staff on how to best employ the discharge planning process, skilled nursing facilities so as to see patients receive proper post-acute care services.

The issue came bulging out as there have been complains that Medicare spends a lot of money on post-acute care but ironically, it has been hard for patients to select the best facilities.

 No value for money

The MedPAC staff established that out of 84.3% of  post-acute-care facility who got discharged to an identified post-acute-care facility had one better home where they could be taken to while the remaining 46.8% had at least more than five better post-acute-care homes to accommodate them.

Hospital discharge planners are not mandated to suggest a specific post-acute-care provider to their clients.

Evan Christman, who is a staff at the MedPAC, stated that this issue is approached by generating a list of good quality providers which should be shared with their clients.

The hospitals, Evan said then needed to collect and also review data on performance of the post-acute-care  providers besides also ensuring that they keep a an official record of the process.

Further, the official added that the hospital must stick to the prescribed Medicare quality rules.

“Medicare will then account for the variation in the post-acute-care provider quality and may also entail specific information on how a facility stands out against other market rivals,” said Evan.

Brian DeBusk, PhD, of DeRoyal Industries in Powell, TN disagrees on using the prescriptive claiming that it makes hospital appear like Medicare agents and exudes optimism that the flexible approach is a bit a fair way to go but also not the best.

Instead, he recommends that the standardized measures of the facilities should be taken and the exposed to what he termed as a standardized peer grouping methodology.

After this, he stated that the end result will be a prescriptive approach where the outcomes were stratified and this will be pinned on a socio demographic status.

“Results could then be used for care giving,” he explained.

Craig Samitt, MD, MBA, of health insurer Anthem, in Indianapolis, wondered why the prescriptive approach was not embraced noting that it was worth exploiting.

“I support the prescriptive approach. It is true that patients are thirsty for this information and it is sad we have not given them anything worth the information. What we have issued is likely not to be perfect, but we should also not let the perfect perspective to be a foe of the good,” said Samitt.

Way forward

The commissions’ Chairperson Crosson, MD, of Palo Alto, CA noted that the solution to the impending matter was just one, but it was unfortunate the members had not reached a consensus.

To address this, Crosson pledged to include information on the issue in June when the commission will have drafted a report to congress.

“However, we will continue to deliberate on the issue to see that a sustainable agreement is reached,” promised Crosson.