Medicare A Trends In Skilled Nursing

According to the latest data from CMS, the usage of Ultra High in the Skilled Nursing setting continues to increase. 60.9% of patient's days in Rehab are now Ultra High. That's nationally though. What about on the state level?

The chart below shows all the states and the District of Columbia. The left side of the chart shows the order the states were ranked in 2013. The states with the highest percentage of Ultra High days are at the top. The right side shows the rankings for 2014. The line between indicates the movement. The width of the line indicates the number of UH days billed.

A few things stand out to me:

  • Florida is still the king of Ultra High therapy. 73.1% of rehab days were UH in 2014. The rate of growth is 3rd from last (1.4%) however. Perhaps we are nearing the limit?
  • Texas and New York are increasing Ultra High utilization at an amazing rate. These are two very populous states increasing around 7% annually. These two states combined for more than 20 million UH days in 2014. I don't expect growth to continue at this rate in Texas in 2015. Look for more like half of the current growth rate.
  • Rhode Island is the only state that actually decreased usage of Ultra High. (-1.0%) The next closest was Delaware with an increase of only 1.2%. Rhode Island dropped from 15th to 23rd place. I searched for possible reasons for the drop and didn't see anything. Rhode Island is definitely an outlier. If you have ideas please let me know.
  • Although it doesn't represent a lot of patient days, New Mexico increased 6 spots to number 14. New Mexico is part of the "UH Band" that runs through the West and Southwest of the country. (See below)

Look for between 62.9% and 65.3% average for 2015 nationally. Contact me for state average estimates.