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Post-acute care (PAC) encompasses the treatments
that patients receive after they are discharged
from the hospital, including services provided
at skilled nursing facilities, inpatient
rehabilitation facilities, long-term care
hospitals, and home-health agencies. Spending on
PAC has grown over the past few decades, and it
now represents a significant expenditure for
accountable care organizations (ACOs), which are
responsible for cost, quality, and utilization
across the continuum of care.
Based on multiple analyses, there is wide
variation in the utilization of PAC, which is
not explained by patient characteristics. In
order to control costs, healthcare organizations
with value-based contracts need to actively
manage the PAC that their patients receive
through focused strategies, such as selecting
the most appropriate PAC facility for each
patient, controlling lengths of stay, and
working collaboratively to reduce hospital
readmissions. Understanding the dynamics of
these issues requires a multi-dimensional
approach.
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