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.