Medicare Post-Acute Care: Quality Measurement Final Report. VI. NEXT STEPS


The instruments developed under this study for each of the four tracer conditions are available to others interested in conducting research measuring the outcomes of post-acute care for patients with these conditions.

ASPE has contracted with the University of Colorado Health Sciences Center and Mathematica Policy Research, Inc., to conduct a national study that will utilize the instrument developed for stroke patients to evaluate, in a post-PPS environment, the outcomes and costs of post-acute care provided in SNFs, rehabilitation hospitals and HHAs. This national study of stroke patients is intended to address several questions about Medicare beneficiaries who are discharged from hospitals to post-acute care, including:

  • What are the demographic and health-related characteristics of patients admitted to post-acute care, including persons who use multiple post-acute providers (e.g., SNF followed by HHA, or IRF followed by HHA)? What are the similarities and differences between patients admitted to the three settings or multiple settings?

  • What patterns of post-acute provider use are most prevalent for these patients?

  • What are the health, functional, quality of life, and other outcomes for beneficiaries treated in HHAs, SNFs, IRFs, or in multiple post-acute settings?

  • Which post-acute setting, or combinations of settings, provides better outcomes and quality of care for similar patients with stroke, after controlling for case mix differences?

  • How does the mix and intensity of services provided in HHAs, SNFs, IRFs, or in use of multiple post-acute settings compare?

  • To what extent do Medicare expenditures and costs differ for similar patients treated in different post-acute settings, or combinations of settings?

  • What core outcome and quality measures are most useful to incorporate into ongoing reporting requirements to monitor the quality of post-acute care for stroke?

This project, funded by ASPE in 1999, will be completed in January 2004.