How IDSs can turn BBA postacute care provisions to their advantage.

Reductions in payments imposed by the Balanced Budget Act of 1997 may force postacute care providers to impose limits on the number and acuity of patients they can accept. As a result, integrated delivery systems may face reduced access to postacute care. An integrated delivery system's financial well-being may be undermined if its only alternative is to care for postacute care patients in high-cost, acute care settings. To address this problem, IDSs should analyze the financial impact of the Balanced Budget Act and share results throughout their systems, determine how financial incentives affect postacute care utilization, conduct interviews to garner support for strategic objectives, evaluate current operational policies and procedures to determine whether they meet Balanced Budget Act requirements, assess their demand for postacute care services, and develop strategies that fairly distribute the impact of changes among all constituencies.