Hospital discharges to post-acute care on rise

The annual number of patients discharged from U.S. community hospitals to home health care rose 53% between 1997 and 2006, while the number discharged to long-term care and other facilities rose 30%, according to a new report from the Agency for Healthcare Research and Quality. According to AHRQ, the increases in part reflect the rising number of hospital patients who are acutely ill. Total annual discharges from community hospitals rose 14% over the period, while Medicaid discharges grew 36%, uninsured discharges 34% and Medicare discharges 17%. The data is from the 2006 Nationwide Inpatient Sample, part of AHRQ's Healthcare Cost and Utilization Project.

To see a copy of the report go to

CMS issues HHPPS notice

The Centers for Medicare & Medicaid Services (CMS) issued a notice to update the Home Health Prospective Payment System (HH PPS) for calendar year 2009. Medicare payments to home health agencies will increase by an estimated additional $30 million next year as a result of a 2.9% increase in the annual market basket calculation of the cost of goods and services included in providing services under the HH PPS. The update also accounts for a 2.75% reduction to the HH PPS rates (the second year of a 4-year phased in reduction) to account for the changes in case-mix that are unrelated to patients' health status, and an updated 2009 wage index.

A copy of the notice (CMS-1555-N) is available on the CMS website at:

Alliance to sponsor home health education and research

A group of home health organizations have formed the Alliance for Home Health Quality and Innovation (AHHQI) to support education and research, and to demonstrate the value of home-based care to patients, their families and policymakers.

The group is dedicated to improving the nation's health care system through solutions that include high quality, cost-effective home-based care models. This initiative comes at a time when policymakers are grappling with a changing health care landscape in the face of rising costs and patient demands for high quality, innovative health care approaches.

"The home health industry offers a well-developed delivery system of high quality, lower cost health care services — one of the most efficient and effective systems that exists in health care today," said Bill Borne, Founding Member of AHHQI and chief executive officer of Amedisys. "The Alliance will demonstrate the readiness of the home health care industry to offer this delivery system as a key component in implementing new and innovative initiatives to meet the health care needs of our nation, particularly for America's seniors." To learn more about AHHQI, go to

Palliative care access varies widely

Although more than half of the 50-bed or larger hospitals in the United States offer palliative care services to ease pain and suffering for seriously ill patients and their families, the availability of these services varies widely across geographic regions, according to a recent study.1

Whereas in 2000, only a few hospitals in the United States provided palliative care services, this report documents a steady overall increase in adoption of palliative care, with 52.8% of hospitals surveyed offering services aimed at alleviating pain and suffering. The number of large hospitals (more than 249 beds) with palliative care programs has increased to 72.2%, while fewer small hospitals (fewer than 50 beds) reported offering those services. Growth in palliative care has occurred primarily in not-for-profit hospitals and has been most notable in the midwestern and western regions of the United States.

"This paper documents the success and applicability of this new field of medicine in American health care," says Charles F. von Gunten, MD, PhD, editor-in-chief of the Journal of Palliative Medicine and provost, Institute for Palliative Medicine at San Diego Hospice. "I hope it leads to the patient expectation that the expert relief of suffering will be as routine in hospitals as cardiology or surgery."


1. Goldsmith B, Dietrich J, Du Q, et al. Variability in access to hospital palliative care in the United States. J Palliative Med 2008; 11:953-1,060.