From 2005 through 2010, swing-bed utilization and Medicare spending at critical access hospitals increased significantly, according to an analysis from the Office of Inspector General (OIG) of the Department of Health and Human Services.
The report evaluated a random sample of 100 critical access hospitals and found that 90 percent of the swing-bed services could have taken place at another hospital within 35 miles. If those services occurred at skilled nursing facilities, it would have saved Medicare $4.1 billion during the six-year period.
Brian Anderson, an OIG auditor, said in a podcast that critical access hospitals typically have higher Medicare payment rates than other facilities. Critical access hospitals are small and rural and usually at least 35 miles from another hospital. He defined swing-bed services as patients being able to move from inpatient services to skilled nursing care without leaving their bed or hospital.
Swing-bed usage at critical access hospitals increased from 789,000 days in 2005 to 914,000 days in 2010, while Medicare expenditures for the services nearly doubled during that period to $1.1 billion in 2010.
The OIG recommends that the Centers for Medicare & Medicaid Services (CMS) ask Congress to adjust swing-bed reimbursement rates at critical access hospitals to the lower rates paid at alternative facilities. The OIG said CMS agreed swing-bed utilization has increased at critical access hospitals, but it disagreed that payments should be decreased because of the lack of similar services at nearby facilities. CMS also disagreed with OIG’s calculation of savings, according to the report.
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.