Empowering Health Care Consumers

Grantee Name

United Hospital Fund of New York

Funding Area

Empowering Health Care Consumers

Publication Date

November 2019

Grant Amount


Grant Date:

November 2017 - October 2018

Each year, approximately 1 in 5 hospital patients in the United States, including some 300,000 New Yorkers, require continued care following hospital stays for major surgery or serious illness.

Yet too often, patients and their families do not have the critical information and support they need to carefully assess their options and make the best possible decisions. Post-acute care, including inpatient rehabilitation facilities, nursing homes, home health agencies, and long-term care hospitals, is a critical and growing component of the health care system.

Although there have been recent reforms to smooth the transition of patients discharged from hospitals to post-acute facilities and improve continuity of care, the system is not functioning as well as it should. Current hospital discharge protocols often overlook patient preferences and limitations, and the rush to discharge can lead to poor choices with significant consequences. Helping patients and their families choose the right setting at the right time could improve outcomes and lower costs. In 2017, NYSHealth awarded the United Hospital Fund of New York (UHF) a grant to improve the ability of patients and family caregivers to make informed decisions about post-acute care settings.

Outcomes and Lessons Learned

  • Conducted an in-depth examination of information needs, preferences, and experiences of patients and family caregivers related to post-acute care decision-making through a literature review and interviews with 17 patient and family caregivers.
  • Held eight discussion groups with hospitals in the New York metropolitan area and interviewed five nursing home administrators to understand the discharge planning process and the information and assistance provided by staff to patients and families.
  • Interviewed 25 experts on post-acute care, including consumer advocates, researchers, and policymakers, regarding support, best practices, and barriers and regulations faced during discharge planning, as applicable in New York State.
  • Held a joint convening with NYSHealth to solicit broader perspectives from stakeholders on post-acute care innovations, processes, and models happening in other states and assess their potential for implementation in New York State.
  • Identified best practices to improve discharge planning that addresses gaps in support and information available to patients and families.
  • Published a four-part series of reports that take a broad look at the many factors, including regulation, that make informed decision-making about post-acute care so challenging. The reports also offer specific recommendations and an action plan for improving current practices and support for patients and caregivers:

UHF’s family caregiving team members participated in a webinar for the Family Caregiver Alliance, a national nonprofit caregiver support organization. The webinar covered discharge planning and why it is important, the features of good discharge planning, the roles and responsibilities of various hospital staff, and who to reach out to when problems arise.

In March 2019, NYSHealth hosted a discussion about the challenges that arise in hospital discharge planning, along with the patient perspective on what can be an exceptionally challenging and difficult process. UHF highlighted findings from its report series on promising approaches for supporting decision-making at discharge.

Co-Funding and Additional Funds Leveraged: N/A