Demonstration of the Subacute Care Alternative

This project planned to demonstrate that an intensified program of post-hospital care can improve outcomes and reduce overall health care costs. The Subacute Care Alternative (SCA) involved transitional daytime care (including nursing services, physician visits, therapy, educational services and counseling) as an alternative to inpatient care for a period of two days to two weeks. By offering an intermediate level of care to carefully selected high-risk individuals, SCA was intended to improve the continuity of care after a patient is discharged from a hospital and reduce the incidence of complications and hospitalizations that result when high-risk patients are discharged without adequate support mechanisms outside the hospital. The demonstration was terminated when the Health Care Financing Administration denied the project's waiver request. The researchers prepared a report detailing the lessons learned from the work completed under the grant, including refinement of a specially developed screening instrument to identify those high-risk individuals who should be targeted for the service.