Post-Acute Providers Need to Act Now to Offset Potential Medicaid Cuts

Many healthcare professionals – especially those connected to skilled nursing facilities (SNF) – are extremely worried about the proposed tax plan coming out of the House of Representatives.

The House recently passed a $4.1 trillion budget plan that promises deep cuts to social programs, including removing nearly $1 trillion from Medicaid’s budget over the next 10 years.

There are currently 1.4 million residents in nursing homes and Medicaid covers two-thirds of those residents. If these cuts to Medicaid occur, it is likely that states will restrict coverage or lower payments made to facilities.

“Majority of patients that are on Medicaid live in a nursing home. Patients with Medicare or other insurance stay for a period of time to get better, and then they leave,” said Saqib Akhter, CEO of Post-Acute Analytics, a company that helps health systems and providers monitor their patients in real time outside their four walls.

“Because Medicaid is a stable, recurring revenue for residents that live in an SNF, having a Medicaid population allows an SNF to cover a certain amount of their fixed infrastructure costs, such as utilities, building costs, and basic faculty. If we lower Medicaid rates or the number of Medicaid residents, now those infrastructure costs have to be covered by the non-Medicaid population, which is continuously fluctuating.”

Worried about cuts to Medicaid? Discover how Post Acute Analytics can help. Click here to schedule a personalized discussion. 

Another issue is, on average, the SNFs that mostly rely on Medicaid have lower overall quality-rating scores than those with a predominately non-Medicaid population. That’s according to a Kaiser Health News analysis of ratings from the federal government’s Nursing Home Compare website.

The research found that one of the biggest reasons for this disparity is nurse and aide staffing. The government rates nursing homes on an ascending scale from one to five stars. The average five-star home has enough staff to provide 5.4 hours of daily care for each resident, while the average one-star home provides 3.0 hours of care a day per resident. If the cuts to Medicaid occur, these staffing disparities are likely to get worse.

“There is a direct correlation between staffing ratio in nursing homes and quality-of-care outcomes,” said Akhter. “So, we don’t want the staffing ratio decreasing. The only way to close that gap is the SNF needs to get a greater amount of transitional care, non-Medicaid patients. And the only way to do that is to show to your hospital referral sources that you are making an effort to do a better job of taking care of their patients and that your quality scores are good and are improving.

“A solution like our Partner Monitor Scorecard enables that. The Partner Monitor Scorecard empowers post-acute providers to share conclusive data with healthcare providers that they are a strong provider and continuously making improvements. Therefore, patients that are going to post-acute providers would benefit by going to that facility. That will allow the SNF to offset any adverse impact they may have from lower Medicaid patients and lower Medicaid rates.”

In addition, utilizing a solution like Post Acute Analytics will enable an SNF to gain valuable insights. The information generated will help the SNF identify their strengths and address their weaknesses.

“Post Acute Analytics helps post-acute providers understand how they are being viewed by their referral sources, so that they know what areas to improve upon. The first step to getting better is knowing where the gaps are, and Post Acute Analytics can provide this information,” said Akhter.

“There are a lot of post-acute providers that are doing a great job but have not been able to differentiate themselves from their competition. They are getting lost in the noise, because everybody uses self-reported data so everybody is showing that they do a great job. Our data from post-acute providers is fully automated (providers don’t have to manually collect any data) and is risk adjusted.  So, if a post-acute provider has worse outcomes because they are taking sicker patients, we adjust for that.  Post-acute providers can use the data gained from our solution to show hospitals proof. We are a third-party system that is simply comparing their efforts to that of their competition, apples-to-apples. It’s information that can help strong and continuously improving SNFs support and strengthen relationships with hospital referral sources while helping them stand out from the competition.”

Post Acute Analytics can help post-acute providers close care gaps and improve quality-rating scores. To learn more, click here to schedule a personalized discussion. 

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