More Information on the Cost of Post-Acute Care

In a recent Forbes post, I wrote about geographical variation in healthcare expenses, and pointed out that a lot of this variation occurs after people leave hospitals. That’s when people end up in nursing homes, rehabilitation facilities and the like. Well it turns out, not only is there great variation in these expenses, but these are also places where healthcare costs have risen relatively quickly over the past 15 years. Consider these data from a recent study in Health Affairs:

The hip fracture data is especially notable. The cost of acute care – presumably of the surgery and postop recovery – has risen pretty slowly over this time period. But once you leave the hospital? Much more dramatic increase in expenses. I’m curious to hear people’s ideas on why expenses have grown so much more rapidly in the setting. Are insurance companies less able to negotiate the cost of post-acute care? Will bundled payments take care of this problem?
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PeterUbel