It isn’t a secret that the post-acute care industry is changing. Over the last decade, there have been two significant structural changes in the market: Medicare’s movement away from a fee-for-service pricing model to a value-based care model, and the growth of Medicare Advantage. These shifts present multiple challenges for skilled nursing facilities (SNFs).
The shift from fee-for-service to value-based care has substantially increased downward price-pressure on SNFs. Reimbursements from Medicare are at one of the lowest points in a decade. In fact, the average price per bed for SNFs dropped 18% from last year. Further, the growing prevalence of value-based reimbursement motivates hospitals to discharge fewer patients to SNFs, reducing overall SNF occupancy rates. Patients are now more likely to be discharged to home with alternative post-acute services such as home health or other in-home care in order to lower healthcare costs. In some instances, hospitals are referring patients only to a small, curated network of preferred skilled nursing providers, further limiting certain SNFs.
Additionally, the increasing market share of Medicare Advantage (MA) health insurance plans has also constricted demand for SNFs, as the plans generally offer enrollees fewer SNF options than traditional Medicare. This translates into a small but notable reduction in the number of seniors who have access to the highest-quality SNFs.
In response to these challenges, the post-acute market, like many competitive environments, has experienced a wave of mergers and acquisitions, particularly among skilled nursing facilities. Larger SNFs are acquiring smaller operations and sister skilled nursing centers are consolidating in order to pool resources and increase their efficiency.
Thriving through the Change
In a market in turmoil, growth-oriented SNFs can tap into practical tools that improve care efficiency and enhance care provider flexibility. Such tools yield improved results across patient care and partner relationships, giving SNFs who adopt them a vital competitive edge in an increasingly crowded market.
Digital tools like Dina enhance referral and discharge management by streamlining workflows across teams, increasing communication with upstream and downstream partners, and providing increased visibility into data and processes. By collecting, aggregating, and reporting patient data in a timely manner, skilled nursing facilities can differentiate themselves as preferred provider partners. This increased communication and visibility helps SNFs demonstrate the value they provide to their patients and their partners.
Real-time care coordination tools can increase consistency across teams despite changes in staff. They also increase efficiency by eliminating gaps in communication, streamlining the workflow within and between care teams. By using smarter communication tools, care providers can eliminate the “phone tag” that often occurs during patient care transitions and ensure that no data are lost, thereby avoiding relapses that incur both human and financial cost.
Patient population projections are growing alongside shortages in nursing staff over the next decade. By leveraging AI tools like DINA to make informed placement decisions for patients, SNFs can proactively provide not just information but recommendations, these tools can take an incredible load off of staff and empower them to focus on patient care. The skilled nursing facility industry is moving into a new era. For facilities to thrive, they must embrace the use of digital, data-driven platforms like Prepared Health and DINA.