Today skilled nursing providers face a new Medicare payment system and macro-level moves toward value-based care, which means the pressures are mounting. The Patient-Driven Payment Model (PDPM) will upend the Medicare reimbursement system, while state-level Medicaid issues continue to strain long-term care providers. These factors may seem daunting, but one tool is rising to help combat these challenges: telehealth. Telehealth is being used not only to improve care but also to maximize operations outcomes.
The Rise of Telehealth to Maximize Income and Improve Care
Amid a world-historic pandemic, telehealth technology can be a game-changer for post acute care facilities. Virtual interventions can roll out rapidly changing strategies for caregivers to provide skilled care and limit outside contact.
Skilled nursing leaders that use telehealth in an uncertain time will be able to control their destiny in the present and future. As margins tighten in a post acute and skilled nursing setting, using telehealth can improve the quality of care by increasing physician interaction. Telehealth technology allows nursing staff to connect directly to doctors even in high demanding times. Connecting with physicians any time day or night brings cost savings while decreasing in-person interactions.
Facilities that use telehealth can also help reduce patient complications. A nurse using telehealth can start a video chat with a licensed doctor who can evaluate the patient in place. Therefore, decreasing the need for costly and potentially disruptive transportation trips to a hospital or medical office.
In 2017, a study was conducted to show that acute care systems are leading the charge on telehealth implementation overall. In 2016, telehealth reimbursements totaled $28.7M from Medicare Part B. As telehealth continues to mature, large-scale programs have become more common: 13% of organizations with telehealth programs completed more than 10,000 consults in 2018, which is more than double two years prior. The continued increase in telehealth growth overall and interest from payers and providers presents an opportunity for post acute facilities to build a strong telehealth footprint.
Telehealth is Foundational to the Value-Based Care Revolution
The use of telehealth services in post acute care can provide better outcomes at a fraction of the cost defining value-based care. Skilled nursing facilities face constant pressure to cut readmission rates to prevent penalties. Implementing telehealth to focus on reducing readmissions can garner impressive short term results.
Value-based care is balancing the cost of providing care against the outcome. Bringing telehealth into play, the balancing act becomes easier to navigate. Reducing readmissions is essential to post acute care facilities and using this technology can serve as a solution for doctors and nurses to monitor patients’ needs more easily.
Using telehealth you may ask, how secure is this with HIPAA requirements? Using HIPAA compliant video conferencing software, physicians can examine patients remotely while complying with regulations.
Telehealth’s Role Under PDPM
The Patient-Driven Payment Model, which went into effect October 1, 2019, classifies patients in a covered Part A stay. Centers for Medicare and Medicaid Services (CMS) elected to base payments on patient complexity rather than basing Medicare reimbursements on the volume of therapy provided. Traditional Medicare only covers telehealth services for rural facilities, CMS has recently moved to encourage Medicare Advantage plans to embrace telehealth, taking a step in the right direction for all patients.
Per a CMS fact sheet: “Skilled therapy services will still be reimbursed by Medicare under PDPM. While PDPM does change the manner in which patients are classified into payment groups under the SNF [prospective payment system], it does not change any of the coverage criteria or documentation requirements associated with the skilled therapy service coverage under PDPM. More important, PDPM does not change the care needs of SNF patients, which should be the primary driver of care decisions, including the type, duration, and intensity of skilled therapies, made on behalf of SNF patients.”
Assessing Programs at South Coast Post Acute
The potential for telehealth at our facility presents challenges and opportunities. Key considerations have been looked into to weigh prior to program development. As an organization, we are considering balancing both the investment challenges and improved outcome opportunities before moving forward.
At South Coast Post Acute, we have a strong commitment to our work and a dedicated spirit of caring within our post acute care community. Because of this, we’re the recovery center of choice for patients, providers, and caregivers. In a time where health concerns are at an all-time high, our knowledge of medicine and tools can make a difference.
Exceptional, compassionate care; every time, every touch. Contact us today!