Value-Based Care Through Postacute Home Health Under CMS PACT Regulations

AJMC February 4, 2022
Patrick Racsa, MS, Teresa Rogstad, MPH, Brent Stice, MBA, Matthew Flagg, MBA, Chase Dailey, MBA, Yong Li, PhD, Brittany Sallee, BS, Karen Worley, PhD, Anup Sharma, MD, David Annand, MD

Among a patient population defined by CMS postacute care transfer regulations, home health vs no postacute care was associated with reduced 30-day readmissions and costs.

ABSTRACT

Objectives: To assess in a Medicare Advantage population (1) whether discharge to home health, compared with discharge to home, following an inpatient stay subject to CMS postacute care transfer (PACT) regulations, is associated with better outcomes or lower expenditures and (2) whether the impact differs among subpopulations.

Study Design: Claims-based retrospective cohort study.

Methods: Instrumental variable (IV) analysis, with prior hospital-level probability of discharge to home health as the IV, to control for unobservable as well as observable confounders.

Results: Compared with 15,071 patients discharged to home, 4160 patients discharged to and receiving timely...

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