How LTACHs are reimbursed

During the first six months in its initial data collection period, a long-term acute care hospital, LTACH, is paid under short-term DRG’s. This period of time is generally referred to as the “penalty period” because LTACHs experience a significant revenue loss due to the fact that all Medicare patients must have an aggregate length of stay of more than 25 days while payments under short-term DRGs are typically based on a length of stay between four to seven days.

Once the hospital has completed its six-month data collection period and has met the greater than the 25-day length of stay requirement for its Medicare patients, the facility is reclassified as a LTACH. Once so designated, LTACHs are reimbursed through specific long-term care DRGs (LTC-DRGs).

These LTC-DRGs have the same definitions as the short-term acute DRGs but, to compensate for longer staying patients, these facilities have much higher relative weights applied to a higher base rate payment.

For more information on our expert LTACH consulting strategies, please visit our LTACH service page. At Advis, we are experts in what we do. Contact us today or call (708) 478-7030.