• Hospital finance and policy leaders
Key metrics and Analyses
- Financial Impact
- Estimate the revenue impact of PACT on your hospital
- Identify chief sources of revenue losses
- Length of Stay Analysis
- Isolate MS-DRGs where the average LOS is close to the GMLOS
- Post-Acute Care Utilization
- Target MS-DRGs where the level of PAC utilization diverges from cohort trends
Each year, 1,300+ hospitals each lose more than $500,000 in Medicare FFS inpatient revenue because of the Post-Acute Care Transfer (PACT) policy—but many organizations remain unaware of its impact. When the PACT policy was introduced in 1998, it was designed to curb payment duplication as hospitals shifted patient care to the post-acute setting. Under the policy, inpatient reimbursement is reduced when hospitals discharge certain patients to a qualifying post-acute care setting earlier than CMS’ stated average.
Our updated PACT impact assessment provides insight into specific cases and service lines most at-risk under the PACT policy. We expect this analysis will be of interest to hospital finance and policy executives. It may help to assess potential revenue implications and to shine a spotlight on areas where improved discharge practices and documentation may be warranted.
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Prior authorization market trends 2020