Integrating Acute and Post-Acute Care: The Emerging Merging of the Sectors

The growth in expenditures for health care is a national challenge that will not be addressed without fundamental change in the economic incentives of reimbursement. While only a partial cause, uncoordinated acute and post-acute care delivery systems have contributed to the increase in national health expenditures. CMS appears intent on creating a reimbursement framework that will incentivize closer relationships between providers to look at cost of care from a patient and episodic perspective. With the evolving fee-for-value payment system, it is important for hospitals and post-acute care providers to consider their organizations part of a broader care delivery ecosystem and that some level of integration will be an imperative for long-term success. This issue discusses the evolving path from the familiar fee-for-service system to one that will be characterized as fee for value. Fee-for-value reimbursement, like bundled payments, and payment penalties relating to hospital readmissions, will require hospitals and post-acute care (PAC) providers to be better integrated in order to control costs and maintain positive margins.