Did Site-Neutral Payment for Long-Term Care Hospitals Reduce Financial Incentives to Time Discharge?

Historically, fee-for-service Medicare reimbursed long-term care hospital (LTCH) stays as a lump-sum payment, which was substantially reduced for discharges before the diagnosis-specific short-stay outlier (SSO) threshold day, leading to large spikes in discharges on the threshold day. The objective of this study was to examine if LTCHs similarly time discharge at the SSO threshold for blended site-neutral payment cases compared with standard payment cases.