Evolution of transitional care settings: past, present, future

Area of Science:

• Healthcare Management
• Health Services Research
• Nursing Practice

Background:

• Medicare prospective payment systems have significantly influenced acute hospital reimbursement and patient length of stay since the 1980s.
• This evolution has led to the development of various transitional care settings beyond traditional acute care hospitals.

Purpose of the Study:

• To define and describe the evolution of transitional care settings.
• To analyze the impact of reimbursement issues on these settings.
• To project future trends and the role of advanced practice nurses within these environments.

Main Methods:

• Literature review and analysis of healthcare policy changes.
• Examination of reimbursement models affecting transitional care.
• Synthesis of current trends and future projections in transitional care.

Main Results:

• Transitional care settings include hospital-based transitional care units, freestanding nursing facility subacute units, and long-term care hospitals.
• Reimbursement policies are a critical factor shaping the development and operation of these settings.
• Advanced practice nurses are expected to play an increasing role in both referring patients and practicing within transitional care settings.

Conclusions:

• Transitional care settings are a dynamic component of the healthcare system, shaped by economic and policy factors.
• Understanding the evolution and reimbursement landscape of these settings is crucial for healthcare providers and policymakers.
• The future role of advanced practice nurses in transitional care presents opportunities for expanded practice and patient management.