Public Policy and Advocacy

ALTHA is proud to represent the nation’s leading Long Term Acute Care (LTAC) hospitals in the nation's capital.

ALTHA represents over three hundred LTAC hospitals across the United States, constituting over three-quarters of this provider community nationwide.

The Post-Acute Continuum of Care

In the past 20 years, health care provided after the general acute hospitalization has become known as “post-acute” care. Included in this term are LTAC hospitals, inpatient rehabilitation facilities (IRF), skilled nursing facilities (SNF), hospices, home health and others. LTAC hospitals are a critical part in this continuum of post-acute care, providing a specialized level of care to medically complex patients that is not offered elsewhere.

Post-acute healthcare providers play an important role in meeting the needs of an important patient population. The continuum of post-acute care that can be quite confusing for policymakers, payers and patients in determining which healthcare setting is the most appropriate for patients with certain medical conditions.

ALTHA believes that the federal government’s post-acute care policies should be guided by four overriding principles.

1. The Federal government should recognize that each healthcare provider in the post-acute sector plays a critical and distinct role in meeting the needs of the post-acute patient population.
2. ALTHA supports the principle that patients should be cared and paid for in the most appropriate setting. MedPAC’s recommendations and CMS’s current research on revised certification criteria for LTAC hospitals are designed to achieve this goal. While determination of appropriate setting is a complicated decision requiring extensive input from treating physicians in consultation with patients, ALTHA agrees with the premise of MedPAC’s recommendation that the decision should be made based primarily on patients’ clinical characteristics and needs. Patients who can be safely and effectively cared for in SNFs should not be treated and paid for in LTAC hospitals or IRFs. Conversely, severely ill, medically complex patients with multiple co-morbidities should have access to the intensive interventions only available in LTAC hospitals.
3. CMS policy should require not only that patients be placed in the appropriate setting, but that providers in the post-acute sector have the capacity to meet the needs of the patients.
Staffing levels, staff skill mix, availability of diagnostic tests, sophistication of technology and intensity of service vary significantly across post-acute settings.
4. ALTHA supports CMS’ efforts to explore and evaluate development of a comprehensive post-acute assessment tool. Development of such an instrument is an important prerequisite to integrating care, and possibly payment, across the post-acute setting. We caution CMS, however, that development of a common instrument is a complicated and important task.