Examining Post Acute Care Relationships in an Integrated Hospital System. 3.9.5 Ordinary Least Squares Regression Predicting Post-Acute Care Episode Payment


In the regression predicting PAC episode payments, increasing severity is associated with increases in episode payments. For example, in the model using MS-DRG severity measures and HCCs (Set 3, Table 3-27), beneficiaries with MS-DRG w/MCC have $6,313 higher episode payments compared to beneficiaries in the lowest severity level. The magnitude of the impact of particular comorbid conditions is also demonstrated in looking at the coefficients for the HCC variables in this model Beneficiaries with HCC 158 Hip Fracture/Dislocation and HCC 79 Cardio-Respiratory Failure and Shock were associated with the largest increases in episode payments. These conditions may be proxy measures for frailty or other unmeasured signs of general decline.

Increasing age was associated with increasing episode payments except for beneficiaries aged 85 or older. Female beneficiaries were associated with lower episode payments and beneficiaries on Medicaid had higher episode payments. Across the models, episode payments were lower for all census regions than for New England with the exception of the Middle Atlantic. Across all models the presence of a colocated post-acute provider or a post-acute subprovider was associated with increases in episode payments.

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