Health care facilities have been tracking and measuring their success for many years related to clinical outcomes and while the cost of care to produce successful clinical outcomes has always been a key factor in overall analysis of results, it is becoming more and more crucial that in order to compete in today’s market, one must produce not only good quality clinical outcomes but also demonstrate the least financial cost for the beneficiary, third party payer and local referral sources.


Length of stay is becoming a key indicator that providers must learn to manage in order to effectively partner with local referral sources as well as to negotiate and maintain managed care contracts, participate in a bundling arrangement or secure a seat at the ACO table.


Post-acute care efficiency is related to three things: hospital readmissions, skilled nursing facility length of stay, and use of high-cost PAC settings (for example, long-term acute care hospitals and inpatient rehabilitation facilities instead of SNFs, or SNFs instead of home health).


The winners in this changing health care market will be able to demonstrate their efficiency by presenting both their efficiency and quality story. Length of stay must be critically analyzed—are there opportunities to provide the same clinical outcome with a lesser length of stay? Can you partner with home health agencies to include this avenue in your discharge plan and decrease your length of stay along with maintaining excellent clinical outcomes and increasing patient satisfaction by returning them to their home environment as soon as feasible? Even if you have a higher length of stay, be prepared to explain how your care can prevent hospital readmissions or how the patient needed managed in the SNF setting because of multiple comorbidities and how the cost of care in your setting is less than in a LTAC or IRF. Be ready to explain how your clinical and financial management of patient risk can be part of the post-acute strategy going forward—demonstrate your leadership in becoming part of the team that works together for the end result of excellent patient care.