Skilled Nursing Facility Utilization Management in a Risk-Sharing Environment in the Community

Post-acute care (PAC) has been one of the fastest-growing segments of Medicare spending in the past 2 decades.1 More than 40% of all Medicare fee-for-service beneficiaries who were discharged from hospitals received PAC.2 Skilled nursing facility (SNF) care expenses rose from $12 billion in 2001 to $29 billion in 2013 at an average of 7.6% annual growth.3 Furthermore, PAC utilization determines hospitals' per-beneficiary cost of care. High per-beneficiary cost hospitals spend approximately $2200 more than low-cost hospitals annually, with PAC being a large driver for the difference.