Research Conducted at Cleveland Clinic Has Provided New Information about Insurance (High-intensity Home-based Rehabilitation In a Medicare Accountable Care Organization): Insurance

Health Policy and Law Daily

2025 MAR 03 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Investigators publish new report on Insurance. According to news reporting from Cleveland, Ohio, by NewsRx journalists, research stated, “Patients are often discharged to a skilled nursing facility (SNF) for postacute rehabilitation. Functional outcomes achieved in SNFs are variable, and costs are high.”

The news correspondents obtained a quote from the research from Cleveland Clinic, “Especially for accountable care organizations (ACOs), home-based postacute rehabilitation offers a high-value option if outcomes are not compromised. The objective was to compare outcomes for episodes in a novel high-intensity home-based rehabilitation (HIHR) modelvs an SNF. Retrospective cohort study. Medicare patients from a large integrated multihospital health system who had low to moderate medical complexity and mild to moderate mobility deficits at hospital discharge were included. The primary exposure was discharge to HIHR (intervention) or an SNF (control) after hospitalization. The primary outcome was Activity Measure for Post-Acute Care (AM-PAC) mobility score. Secondary outcomes were Medicare costs within 30 and 90 days post hospitalization, 30-day readmission rate, and index hospital length of stay (LOS). Inverse probability of treatment-weighted regression was used for comparison between cohorts. There were 171 patients discharged to HIHR and 841 to SNFs. The adjusted AM-PAC mobility T-score was 8.2 (95% CI, 6.3-10.1) points higherafter HIHR vs SNF. Adjusted Medicare costs were lowerfor the HIHR cohort (within 90 days, -$17,123; 95% CI, -$20,757 to -$13,490). Hospital LOS and odds for readmission did not differ between cohorts. The HIHR cohort demonstrated better functional outcomes and lower posthospital costs.”

According to the news reporters, the research concluded: “HIHR may be a high-value option for patients attributed to a Medicare ACO who have moderate medical complexity and moderate functional deficits at the time of hospital discharge.”

This research has been peer-reviewed.

For more information on this research see: High-intensity Home-based Rehabilitation In a Medicare Accountable Care Organization. American Journal of Managed Care, 2025;31(1). American Journal of Managed Care can be contacted at: Managed Care & Healthcare Communications Llc, 666 Plainsboro Rd, Ste 300, Plainsboro, NJ 08536, USA.

Our news journalists report that additional information may be obtained by contacting Joshua K. Johnson, Cleveland Clinic, Dept. of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland, OH, United States. Additional authors for this research include Karen J. Green, Mary Stilphen, Michael B. Rothberg, Jessica A. Hohman, Jarrod E. Dalton, William Zafirau, Don Carroll, Steven Pamer, Laura Olitsky and Jessica Marzulli.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.37765/ajmc.2025.89660. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.