Post-acute Planning Benchmarks

Discharge Rate to Post-acute Care – Medicare Only

Discharge Disposition All Medicare (a) Best Practices (b)
Low High
HHA 16.0% 22.0% 24.0%
Hospice 2.1% 2.5% 3.0%
IRF 3.2% 4.0% 6.0%
LTCH 1.0% 1.5% 2.0%
SNF 17.3% 12.0% 15.0%
Total 39.6% 42.0% 50.0%

(a) Source: MedPAC June 2008 Annual Data Book.
(b) Source: Walter Consulting

Estimated Impact of Incremental Medicare Admissions by Post-acute Setting (2009 data)

HHA IRF LTCH SNF
Hospital-based Freestanding
1. Average Medicare Revenue (a) $5,748 $16,586 $37,465 $420 $415
2. Potential Incremental Volume 100 Admits 1 ADC
(28 admits)
1 ADC
(14 admits)
1 ADC
(26 admits)
1 ADC
(13 admits)
3. Incremental Revenue (b) $574,800 $464,408 $524,510 $153,300 $151,475
4. Estimated Total Expenses (c) $473,060 $425,398 $494,613 $254,478 $146,173
5. Estimated Variable Expenses (d) $378,448 $212,699 $247,306 $127,239 $73,087
6. Estimated Incremental Medicare
Contribution Margin (3-5)
$196,352 $251,709 $277,204 $26,061 $78,388

(a) MedPAC Report to Congress, March 2011.
(b) Incremental revenue equal to average Medicare revenue time patient days (SNF) or admissions (HHA, IRF, LTCH).
(c) Total expenses estimated by applying 2009 Medicare operational margins (MedPAC Report to Congress, March 2011.)
(d) Variable expenses assumed to be 50 percent for IRF, LTCH, SNF and 80 percent for HHA.