By Chris Carruthers, Vice President of Health Services Marketing

Skilled nursing facilities (SNF) not only improve the quality of life for residents and provide essential care, but they are also critical assets in the wider healthcare system because they prevent avoidable hospital readmissions. At a time when the federal government penalizes hospitals with high readmission rates, SNFs are valued partners in helping residents receive the highest quality care in order to prevent avoidable hospitalizations and higher Medicare costs.

In order to combat rising penalties and federal spending, the Hospital Value-Based Purchasing (VBP) Program was created.

What is the VBP Program?

The Hospital Value-Based Purchasing (VBP) Program is a Centers for Medicare & Medicaid Services (CMS) initiative that rewards acute care hospitals with incentive payments for the quality of care they provide to Medicare beneficiaries.

Value-based purchasing can be thought of as a broad set of performance-based payment strategies that link financial incentives to providers’ performance on defined measurements, including mortality and complications, patient safety and experience, and efficiency and cost reduction.

Goals for Success

Hospitals and skilled nursing facilities have been forced to quickly improve in order to meet the new VBP standards. VBP programs should affect providers’ willingness to change, adapt a measurement system to identify problems, and be able to respond to correct quality shortcomings.

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Staying Competitive

It’s important to track satisfaction levels in order to remain competitive within VBP markets. Until any changes are made in the Affordable Care Act, hospitals will continue to be required to provide a higher quality of care at a reduced cost, which means that they will continue to partner with SNFs who can show consistent quality outcomes within the appropriate days allowed for rehabilitation under the VBP program.

Communication between hospitals, physicians and SNFs is vital to this system, with each entity needing to consistently provide outcomes and other patient care information on a regular basis through integrated data systems.

Electronic medical records (EMR) allow hospitals and physicians to access medical information that reinforces the relationship with the VBP. Collaboration between all entities allows for conversations about promoting innovation to fix fundamental problems leading to poor quality and outcomes within provider organizations.

Protocols for high-risk patients are a way for SNFs to collaborate with physicians, in order to reduce hospital readmission rates. Risk assessment tools and the provision of clinical decision support are key factors in these protocols.

To remain competitive, many SNFs are now investing in a staff member whose sole responsibility is to provide concierge services. The concierge visits patients on a regular basis in order assure their needs are being met regarding pain management, therapy and overall satisfaction.

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The patient will also complete a standard satisfaction survey that focuses on whether their expectations are being met (or not). The concierge follows up with the patient after discharge to assure they have scheduled any necessary appointments with their physician and makes sure they are able to fill their prescriptions. Some go as far as scheduling the patient’s physician appointment and accompanying them, in order to reduce the risk for hospital readmission. Some even make home visits to higher-risk patients after discharge from the SNF.

In order to remain competitive, these few steps must be taken:

• Track quality metrics in your facility, compare your scores to state and national benchmarks and integrate them into your Quality Assurance Performance Improvement program as needed.
• Implement INTERACT tools if you have not already done so. These are great tools to help you reduce re-hospitalization rates.
• Remember that the VBP relates to re-hospitalization for 30 days from admission. Therefore, tracking after discharge and good communication with home health agencies and other post-acute care providers is a must.

If you would like to learn more about how Love & Company can help your SNF stay competitive within VBF markets, please contact Tim Bracken at 410-207-0013 or Rick Hunsicker at 214-906-3801.