2018 was a landmark year for skilled nursing facilities (SNFs) in regard to Medicare & Medicaid Services (CMS). Strict penalties for readmitting patients within 30 days, namely withholding a percentage of their gross annual budget, meant SNFs quickly reevaluated their value-based care models. They had to find ways to treat patients in place and reduce hospital readmissions.
Now, over two years later, CMS is enacting more changes to which healthcare facilities must adapt. Just as telehealth technologies were used in the past to help SNFs improve patient care and reduce costs, they can be adopted to meet current and future regulations.
Let's explore some of the most recent SNF policy updates and how the use of telemedicine and telehealth can help.
Virtual visits proven successful already
Since the Medicare Patient-Driven Payment Model (PDPM) went into play on October 1, 2019, physician use of virtual visits doubled from only 14% in 2016 to 28% in 2019, according to HealthLeaders. There was a clear push to utilize telehealth with the new CMS system in place. For SNFs in particular, the ability to directly connect with doctors and specialists over video chat or phone makes it easier to save money, improve care for high-risk patients and enhance the experience for everyone involved in the care continuum.
In speaking with Masonic Holmes Kentucky about their experience with the use of telehealth, they were excited to share their biggest win around readmissions. "Since we began using telehealth, our re-hospitalization rates dropped from 27% to 15% at one skilled nursing facility and 20% to 13% at another."
In the 2019 and 2020 Fiscal Year, the PDMP set in motion the rapid adoption of telehealth and a new outlook on how virtual visits improve value-based care. Now, coming up on another annual landmark, new CMS rules mean SNFs and other healthcare facilities must embrace new changes to their care and payment policies.
New CMS rule for 2021
On July 21, 2020, CMS issued new rules for the 2021 fiscal year that specifically updates the Medicaid payment rates and value-based purchasing programs for SNFs. There are a few new changes that every SNF should be aware of, which are as follows:
Increased payments, especially for rural areas
In light of the COVID-19 pandemic and its toll on the healthcare landscape (nursing homes and SNFs in particular), CMS is planning to increase Medicare payments to SNFs by 2.2% ($750 million). In addition to this increase, they will want to know if the facility is urban or rural to calculate the wage index and appropriate funding.
Updates on patient classification
To continue to ensure that SNFs are focusing on the quality of patient care provided rather than quantity, CMS wants these facilities to classify patients into payment groups. Code mapping will help SNFs stay organized while improving CMS's payment methodology.
Finalizing SNF scoring
SNF scores will still be based on their performance on a single claim-based all-case all-conditions hospital readmissions measure. Depending on their success, they can gain incentive payments. Each year, the federal per-diem rate of readmissions is lowered by 2% and so they continue to improve each fiscal year.
How telehealth helps SNFs succeed
With these new policies, investing in telehealth solutions is more important than ever for SNFs. Here are some of the major benefits of telehealth for SNFs:
Increased savings by lowering re-admissions
Typically 78% or more, of all readmissions are avoidable with telemedicine, according to TeleHealth Solution, the telehealth physician service provider for Masonic Holmes Kentucky. Implementing telemedicine at a SNF facility helps avoid lost bed revenue for on average 7 days, plus the cost of the transfer.
As mentioned earlier in this article, Masonic Holmes Kentucky, saw a 44% decrease in their readmission rates. Keeping their readmission rates low year over year will help them gain the CMS incentive payments.
Improved patient outcomes by treating patients in place
Most patients who reside in SNFs need assistance from a specialist professional, but have to wait because it is the middle of the night or the office is hours away and they don't have the resources to travel for an in-person consultation. By using telemedicine, patients and in-facility staff that have the opportunity to consult with specialists from afar and assist in treating chronic conditions at the critical times when their conditions might flare. Not only does this keep resident patients within the facility, it also reduces the risk of infections or complications from traveling to another location for care.
An advantage in the competitive market
When SNFs implement telemedicine, they're setting themselves apart from competitors who don't give prospective families innovative options for communication. They are also positioning themselves to be much more attractive to referring hospitals because they will have much lower readmission rates than a facility without telemedicine.
"The use of telehealth with provider services has improved the coordination of care between hospitals and our facilities, and increased family satisfaction to over 97%, all of this has significantly increased our referral base," commented Conjuna Collier at Masonic Holmes.
Working with an industry leader in telehealth who understands what challenges SNF facilities face will help your facility succeed. AMD Global Telemedicine is your partner in telehealth technology and solutions, not just for today but continuing with you as the healthcare landscape evolves moving forward.
Contact us today to learn more.