For SNFs, changing payment models drive a focus on quality

October 15, 2015 ABILITY

A recent article in HealthLeaders Media outlines the ongoing evolution of SNFs, pointing to the development of new payment models as a major driver of change. “An ever-increasing number of SNFs nationwide are embracing the shift from fee-for-service medicine to delivering quality care at the lowest possible cost,” states the article.

The new focus on quality can be attributed to factors like bundled payments, penalties for hospital readmission, and decreasing lengths in patient stays. One SNF network profiled in the article reports that 75 percent of its patients stay for less than 20 days, demonstrating the dramatic shift for an industry that used to rely on a residential model for revenue.

The new frontier is exemplified by a handful of facilities in Massachusetts, which are participating in CMS’s Pioneer ACO program, allowing them to experiment with new models of care coordination. SNFs in the program are exempt from the three-day rule for Medicare coverage of patient stays, which gives them more opportunities to treat complex patients—for instance, patients who were in the ER only hours before.

More changes like this could help SNFs offset the lower patient volumes that some are experiencing due to the growing emphasis on home health care. So while hospitals may now discharge patients to their homes after a joint replacement surgery, a SNF may be able to treat more patients who, in the past, would have remained hospital inpatients.

The article emphasizes the importance of SNFs deepening their relationships with hospitals to help their businesses adjust to these changes. To do that, administrators should work to maximize their star ratings, and should ensure that their communication and responsiveness are as strong as possible.

While change in the industry is a constant, one consultant points out that a focus on quality can help SNFs stay proactive.

“All you can do,” she tells HealthLeaders, “is provide quality services and be a facility that others want to do business with.”

 

 

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