New Research Finds Long-term Acute Care (LTAC) Hospitals Have Played Critical Role During COVID-19 Public Health Emergency

WASHINGTON, Feb. 16, 2021 /PRNewswire/ -- ATI Advisory (ATI), a research and advisory services firm working to transform the delivery of healthcare and aging services for older adults, released new research findings today highlighting the significant, collaborative role that long-term acute care (LTAC) hospitals have played alongside inpatient hospitals in meeting the public health needs of clinicians, highly medically complex patients, and patient's families during the public health emergency (PHE).

ATI gathered perspectives from healthcare professionals and clinicians in short-term acute care hospitals (STACHs) and in post-acute care, who reported on their experience with patients in both Medicare FFS and Medicare Advantage during the PHE. ATI also analyzed Medicare FFS claims (Q2 2020) to identify early patient trends and to support qualitative feedback. Early data analysis suggests that LTAC hospitals remained a specialty setting appropriate for patients with the highest needs. This is partly demonstrated in the national LTAC hospital Case Mix Index, which increased year over year for national LTAC hospitals (1.199 in May 2019 to 1.242 in May 2020). The average length of stay (ALOS) also increased from 25.3 days to 27.4 days during the same time period.

These preliminary findings support the importance of maintaining a flexible healthcare provider asset class that can serve as a hospital extender during public health crises, and be repurposed to meet non-emergent delivery system needs at other times.

"We found that inpatient hospital colleagues were able to call on LTAC hospitals in their market, who, because of the CARES Act waivers, could be deployed quickly and nimbly into a public health role. They have decompressed the overburdened acute care system during the 'war time' of COVID, with the ability to revert back to their 'peace time' role when the PHE ends," said Anne Tumlinson, CEO of ATI Advisory.

David Grabowski, PhD, a professor of health care policy in the Department of Health Care Policy at Harvard Medical School, recently spoke out on the importance of LTAC hospitals during the PHE, stating: "In a pandemic, you really do need that kind of intensive care. For years, we said, 'Why do we need long-term care hospitals?' And all of a sudden with COVID, we're saying 'Why don't we have more long-term care hospitals?'"

The COVID-19 PHE disrupted long-standing delivery system barriers to continuity of patient care. Under the extreme circumstances of the pandemic - and supported by the CARES Act-Section 3711 waivers as well as prior authorization relief - new operating patterns were instituted that reasserted fluid patient transitions and clinical collaboration, especially between STACHs and LTAC hospitals. ATI's research indicates that the clinical capabilities in LTAC hospitals have been particularly well suited to extend STACH capacity and fill critical care gaps in the post-acute care continuum.

See the full analysis and key lessons for providers, payers, and policymakers to consider:

About ATI Advisory

ATI Advisory is a research and advisory services firm working to transform the delivery of healthcare and aging services for older adults. By providing insight and strategy backed by original research, ATI helps organizations lead and deliver change in senior healthcare and long-term services and supports systems. For more information, visit

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