Post-Acute Care: Savings for Medicare Advantage Plans

Post-acute care spending can be controlled by closely examining two major areas: care  management and network management. CareCentrix estimates that plans can reduce post-acute care costs by 20 to 25 percent through better management of these two major elements.

Post-acute care (PAC) comprises one of every four dollars spent by a  Medicare Advantage plan. For certain conditions, such as congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD), post-acute care contributes nearly 70 percent of the total cost of care. Particularly as health plans seek additional savings to make their Medicare bids more competitive, taming PAC costs represents an important approach to bending the cost curve in healthcare.

This white paper covers:

  • The impact of care management and network management and how it directly effects post-acute care costs
  • The five categories that should be analyzed to find significant cost savings in post-acute care – with recommended action items for each
  • Opportunities for better post-acute care through network management and the two categories recommended for further analysis
  • Implementing an integrated method that is patient-focused with a “home first” approach with the goal of sending patients home as soon as it is safe and clinically appropriate