Healthcare Headlines Blog
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Determining the appropriate post-acute care (PAC) delivery setting for a patient based on his or her medical needs can help improve outcomes and lower total cost of care. While many patients are able to fully recover at a skilled nursing facility (SNF) or at home following a hospital stay, a small percentage of the patient population requires additional critical care and services. Without the proper intensity of acute care and access to physicians and on-site specialized services, these patients are more likely to readmit to the hospital, thereby increasing total cost.
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Compounded by the COVID-19 pandemic and flu season, providers and payors have sought new strategies to address respiratory failure. For patients experiencing respiratory failure conditions, such as acute respiratory distress syndrome (ARDS), specialized acute care after the initial hospital stay is proving to play a critical role in improving patient outcomes, reducing readmissions and decreasing the severity of long-term effects.
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The American healthcare system, already financially strained and facing demanding demographic changes, has been further challenged over the past two years by the COVID-19 pandemic. This unique pressure test has revealed areas for improvement in the American system and highlighted the importance of infection prevention.
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Medically complex patients represent a small, but consequential portion of America’s patient population that can put strain on the nation’s health system if not treated in the proper setting. In order to improve outcomes and lower total costs of care, provider networks must be able to identify these patients and determine the most effective and efficient care delivery pathway for them. A recently-published HealthLeaders e-Book explores some of today’s chronic illnesses and comorbidities and explains why LTACHs are often the most appropriate setting to treat such conditions.
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The pandemic has pushed infection control standards to the forefront as patients and providers are counting on advanced protocols to reduce viral spread and prevent further outbreaks. Now more than ever, it’s important for patients to be treated in a care setting that is not only best suited to their medical needs but also upholds the highest federally and clinically-recognized health and safety requirements.
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In today’s intense healthcare environment, collaboration between acute and post-acute providers as well as payors have been particularly essential. Recent analysis conducted by ATI Advisory, a Washington, DC-based research and advisory services firm, evaluated post-acute provider performance during the public health emergency using claims data from Centers for Medicare and Medicaid Services (CMS).
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Based on continued evaluation of the patients suffering from and recovering from COVID-19, a new subset of patients is emerging, formally called “post-COVID".
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Recent research indicates that respiratory failure poses an increasing challenge for providers and payers, in part due to the COVID-19 pandemic and demographic changes1. In order to optimize outcomes and efficiently manage total cost of care, payer networks should ensure that patients with acute pulmonary conditions have access to the most appropriate level of care.
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The latest research findings are honing in on the clinical conditions associated with COVID-19, along with the specific care pathways needed for patients, once stabilized, to fully recover. Specialized care after the initial hospital stay is proving to play a critical role.
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