Likosky says that the research period did not extend beyond 2008, when new payment policies from the Centers for Medicare & Medicaid Services attempted to reign in ambulatory spending for imaging, and benefits for hospice care were limited.
In an accompanying commentary, Ashish Jha, MD, professor of health policy and management at the Harvard School of Public Health, noted that "the additional spending went toward paying for more skilled nursing facilities, physician's visits, home health care, and durable medical equipment. Although readmission rates in the late period remained stable, the spending per readmission went up—with little evidence that patients benefited."
Jha also noted that not only are these post-acute episode services expensive to Medicare "but to the beneficiaries as well," prompting them to incur "substantial out-of-pocket costs."
Likosky's report, Jha wrote, "should be a wake-up call for federal policy makers" to focus on cost reductions beyond 30 days, and is "a timely reminder of the importance of research and data for policy making."