Post-acute Planning Benchmarks

US 2006-2017 Medicare FFS Discharges Post-acute Care

Discharge Disposition Medicare FFS Discharge Rates (a) Best Practices (b)
2006 2009 2012 2013 2014 2015 2016 2017 Low High
SNF 18.8% 19.8% 20.3% 20.7% 21.0% 21.2% 20.8% 20.7% 16.0% 18.0%
HHA 13.8% 15.2% 15.9% 16.5% 16.8% 16.9% 17.2% 17.9% 22.0% 24.0%
IRF 3.4% 3.3% 3.5% 3.6% 3.8% 3.9% 4.0% 3.8% 4.5% 6.0%
LTCH 0.9% 1.1% 1.2% 1.2% 1.2% 1.2% 1.1% 1.1% 1.0% 2.0%
Hospice 1.6% 16.0% 2.7% 2.7% 2.9% 3.0% 3.0% 3.1% 3.5% 4.0%
Total 38.5% 41.5% 43.6% 44.7% 45.7% 46.2% 46.1% 46.6% 47.0% 54.0%

(a) Source: June 2019 MedPAC Data Book, pg 68.
(b) Source: Walter Consulting

Estimated Impact of Incremental Medicare FFS Admissions by Post-acute Setting – 2018 Data (a)

Financial Indicator HHA IRF LTCH SNF (Freestanding)
1. Average Medicare Revenue (a) $5,303 $20,124 $40,105 $11,592
2. Potential Incremental Volume 100 Admits 1 ADC
(29 admits)
1 ADC
(14 admits)
1 ADC
(15 admits)
3. Incremental Revenue (b) $530,300 $583,596 $561,470 $173,874
4. Avg 2018 Medicare Margin (a) 15.3% 14.7% -5.0% 10.3%
5. Estimated Total Expenses (c) $449,164 $497,807 $589,544 $155,965
6. Estimated Variable Expenses (d) $359,331 $248,904 $294,772 $77,982
7. Estimated Incremental Medicare
Contribution Margin (3-6)
$170,969 $334,692 $266,698 $95,891

(a) MedPAC Report to Congress, March 2020.
(b) Incremental revenue equal to average Medicare revenue per admissions times the number of admissions.
(c) Total expenses estimated by applying 2018 Medicare operational margins (MedPAC Report to Congress, March 2020.)
(d) Variable expenses assumed to be 50 percent for IRF, LTCH, SNF and 80 percent for HHA.