The National Rural Health Resource Center (The Center), supported by the Federal Office of Rural Health Policy (FORHP), convened a virtual summit of key stakeholders to examine the current state of post-acute care (PAC) in rural America. The COVID-19 pandemic has brought PAC/long-term care (LTC) into the national spotlight, as a significant percentage of pandemic deaths in the U.S. are occurring in LTC and skilled nursing facilities (SNFs). Summit attendees explored issues, challenges, and strategies related to the integration of rural acute and PAC and considered how rural PAC can be successfully included in a population health and value-based payment future.
Participants engaged in a wide-ranging discussion about current and often longstanding PAC-focused issues and challenges confronting health care organizations and communities across the rural U.S. In particular, the breakout sessions focused on four major topics, identifying both issues and potential strategies and tactical solutions to address those issues.
Identified Common PAC Challenges
- Impact of the shifting payment environment from traditional volume-driven fee-for-service and cost-based reimbursement methods to value-based payment arrangements
- Need to improve access to rural PAC and services
- Evolving role of technology, particularly the rapid expansion of telehealth in response to the COVID-19 pandemic
- PAC workforce challenges and opportunities
- Importance of addressing social determinants of health
This report provides a background on PAC, the Summit participants, process used at the Summit, comprehensive lists of identified strategies and tactics to address high priority rural PAC issues, a discussion on how state Flex Programs can help rural providers address PAC, and a collection of PAC best practices from the field.