The focus shift in health care delivery from volume to value is getting payers to think more efficiently and effectively regarding site of care. Because one of the most expensive sites of care is the hospital, care has been moving from the hospital setting to the skilled nursing facility7.

There are several financial models and programs that focus on this need to improve the value LTC providers’ care delivery, with more value-based models to come in the near future.

On July 31, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule [CMS-1696-F] outlining fiscal year (FY) 2019 Medicare payment updates and quality program changes for skilled nursing facilities (SNFs).1

This recognition of employees’ importance is what resulted in a proposed fourth dimension to be added to the Triple Aim (enhancing patient experience, improving population health, and reducing costs), as it was felt that achieving the Triple Aim is not possible without an engaged workforce. The additional fourth item—making the Triple Aim into the Quadruple Aim—specifically focuses on the work life and well-being of care professionals.

By requiring attending physicians to be responsible for certain items, SNFs can meet the challenges of this new environment successfully.

Richard G Stefanacci, DO, MGH, MBA, AGSF, CMD, discusses why SNFs are being held accountable for events occurring well outside their facility walls and what adjustments are needed within their care processes. 

Richard G Stefanacci, DO, MGH, MBA, AGSF, CMD, explains how the shift in reimbursement is impacting LTC and provides some insight into how SNFs can address this changing landscape.

doctor handing prescription out

Richard G Stefanacci, DO, MGH, MBA, AGSF, CMD, explains and examines several recently implemented regulatory changes by CMS, which include an expanded definition of psychotropic medications and new limitations on the use of as-needed psychotropic medications within SNFs.

doctor writing on clipboard

Richard G Stefanacci, DO, MGH, MBA, AGSF, CMD, examines the ways in which health systems select their preferred SNF provider networks as their focus shifts to risk-based coordination of care.

New way road sign

Perhaps the biggest concerns right now for long-term care are access to care and the shift to value-based payment instead of fee-for-service.