Q2 2020 Post-Acute Discharge Trends for COVID-19 Patients
A Comparison Using Q2 2019 Data as a Baseline
By: Carter Bakkum | November 24, 2020
In early 2020, COVID-19 drastically changed the landscape of healthcare – especially for acute and post-acute care organizations. As the leader in provider performance outcomes insights and analytics, the Trella Health team anxiously awaited the release of Q2 2020 Medicare claims data – including the first quarter of COVID-19 impacted data- to help us quantify the pandemic’s impact on our industry through June 2020. Below we’ve compiled a brief analysis comparing post-acute discharge destinations from Q2 2019, before the coronavirus pandemic, with destinations for COVID-19 patients discharged from a hospital stay during Q2 2020. This quick overview provides a first glimpse into the impact of COVID-19 on post-acute care, with more details and insights to come as we continue analyzing this data set.
- The percentage of inpatient discharges without post-acute care remained roughly equivalent for Q2 2019 patients and Q2 2020 COVID-19 patients, at 53.6% and 51.8%, respectively
- Patients with COVID-19 diagnoses were three times more likely to be admitted to SNFs than home health agencies upon discharge
- COVID-19 patients were almost 50% more likely to be admitted to hospice care post-discharge than patients discharged during Q2 2019
Post-Acute Destinations Following Inpatient Discharge: Q2 2019
Where do Medicare fee-for-service (FFS) patients typically receive post-acute care from after discharge from an inpatient stay? For a baseline of post-acute care discharge destinations before the current pandemic, we analyzed destinations for all inpatient stays during Q2 2019. The first pie chart represents post-acute destinations within 30 days of discharge from an inpatient stay for all patients in Q2 of 2019. This count is based on total inpatient discharges; individual patients hospitalized multiple times within the quarter are counted for each discharge. We selected the second quarter of 2019 as our baseline to establish where patients are typically referred for post-acute care to account for seasonal variations in post-acute destinations. Findings from this quarter include:
- More than 50% of discharges did not receive post-acute care.
- Around 19% of inpatient discharges were admitted to SNF within 30 days
- About 18% of inpatient discharges were admitted to home health within 30 days
- 5% of patients were admitted to hospice within 30 days of discharge
- 4% of patients were admitted to either a long-term care hospital or inpatient rehab facility
Post-Acute Destinations for COVID-19 Patients Following Inpatient Discharge: Q2 2020
Where did COVID-19 patients receive post-acute care after discharge? Now that we have a baseline for a typical quarter’s post-acute care discharge destinations, we can look at the Q2 destination information for COVID-19 patients in 2020. Like the previous visual, this pie chart represents total post-acute destinations within 30 days of discharge, though it only accounts for patients with a COVID-19 diagnosis.
- Roughly half of COVID-19 patients did not receive post-acute care.
- Discharged COVID-19 patients were three times more likely to be admitted to a SNF than a home health agency.
- COVID-19 patients were nearly 50% more likely to enter into hospice upon discharge than patients in Q2 2019.
Considering these percentages and overall numbers, it’s worth noting the 52,568 COVID-19 discharges do not include COVID-19 patients who died during a hospital stay, patients with COVID-19 who had not yet been tested, or patients awaiting test results at the time of their death. While these numbers may thus be artificially low for total Medicare FFS COVID-19 discharges, we can still infer valuable information from these metrics compared against the same quarter in 2019.
Our analysis of total Medicare FFS patients discharged in Q2 2019 vs. total COVID-19 Medicare FFS patients discharged in Q2 2020 shows a few significant changes. Most notably:
- COVID-19 patients were much more likely to be admitted to SNFs than to home health agencies following an inpatient stay
- COVID-19 patients were 50% more likely to enter hospice care than patients discharged in Q2 2019
Along with our annual Industry Trend Report, we will be publishing additional analyses based on the first quarter of COVID-19 impacted data, including the effects the pandemic had on post-acute admissions and utilization during Q2 2020.