Home Health & Hospice Week

Home care and other post-acute care providers are in the spotlight for increased Medicare spending and widely varying utilization across geographic regions.

For example: "Medicare spends $8,800 on each Louisiana patient receiving home health care, $5,000 more than it spends on the average New Jersey senior. In Chicago, one in four Medicare beneficiaries receives additional services after leaving the hospital — three times the rate in Phoenix," reports the Washington Post. "More than a quarter of Medicare spending in Louisiana, Massachusetts, Mississippi, Oklahoma and Texas was for post-acute care in 2011."

Where patients go after hospital discharge "largely … has to do with the supply of providers and type of providers in the area," Anne Tumlin-son, a consultant at Avalere Health, told the Post.

Highlight: Medicare’s cost for treating stroke patients, including time in the hospital and three months of subsequent care, averages $40,000 if the patient is discharged to an inpatient rehabilitation facility, $33,000 for stroke patients discharged instead to a nursing home, and $13,000 for those in home care, the Post says.

Post-hospital services are the primary reason Medicare spends much more in some parts of the nation than elsewhere, says the article, implying than less costly post-acute care will save the program money.

However, home care spending in 2011 accounted for "a quarter of the reason some areas were more costly than others," the article contends. The article blasts HHAs’ "double digit" profit margin, projected at 12 percent this year.

Medicare’s home health PPS system gives agencies "the incentive … to sign up patients who need hardly anything and sign them up for as long as you can get them," Judy Feder, a professor at the Georgetown Public Policy Institute, told the Post.