Medicare post acute care home health and skilled nursing facility cost growth and proposals for prospective payment t hehs 97 90 published mar 4 1997 publicly released mar 4 1997. Medicare post acute care home health and skilled nursing facility cost growth and proposals for prospective payment scholars choice edition united states government accountability 9781297018213 books amazonca. Medicare post acute care home health and skilled nursing facility cost growth and proposals for prospective payment for each type of visit skilled nursing physical therapy and so on but are applied in the aggregate that is an agencys costs over the limit for one type of visit can be offset by costs below the limit for another both snf. Table 1 nursing facility and post acute care spending2008 medicare s prospective payment system pps for snf services was implemented based on the start of the facility fy on or after july 1 1998 prior to this date snfs were paid on a cost based basis under the medicare snf pps facilities are paid a predetermined daily rate up to 100 days but only after a qualifying hospital . Medicare reimbursement for home health care was significantly lower than for snf care in turn saving the program more money hospital patients discharged to a home health agency reduced the average medicare spending on post acute care by 5384 and cut the overall 60 day episodic cost by 4514 according to the study
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