The Changing Long-Term Care Market

The past week, I attended the #NICForum18 in Dallas. Everywhere I turned there were nursing home and assisted living operators, investors, and owners.

The topics circled around Medicare, health care services, joint partnerships, and bundled payments. I learned so much but most importantly, the long-term care market changes to a more focused patient-care footprint. 

In the past when my dad lived in a nursing home, we got what was available. And that wasn't very much, in my opinion.

There were few options for him living with Alzheimer's disease.

The nursing home where he lived was operated like an institution. His basic needs were met. That's about it. And I mean very basic. There were no special programs to address his cognitive decline or nutritional needs. 

The family had hoped to keep dad at home longer but home care services were a bit archaic back in those days too.

As I sat through the #NICForum18 sessions, they gave me hope for a better caring system for people like me, the over 65 population.

The home care service market now partners with physicians and nurses who make home visits. If dad were alive today, his physician could have come to the house or met with him and the family via online video. 

New features of the ever-changing SNF

The skilled nursing facility of today evolves to a service delivery and care management hub.

They're becoming a key referral partner for an accountable care organization (ACO) or provider network that risks having Medicare reimbursements reduced if quality and cost levels are not met, and receives rewards when and if goals are achieved.

Today, the risk-bearing entity seeks partnership with post-acute providers that deliver on key metrics, such as quality of care, reduced hospitalizations, and shorter stays.

The SNFs now offer multi-faceted services by partnering with technology companies and home care. 

Other services could include on-site primary care physicians and nurse practitioners to deliver clinical programs focused on chronic illness support, cardiac care, orthopedics and other therapies. The transitional capabilities now facilitate better patient transfers to the home. 

The ultimate goal is to reduce costs and best way to do that is to deliver more services in the home rather than in expensive SNF or ALF facilities.

Another concept mentioned by Anne Tumlinson, founder of consultancy Anne Tumlinson Innovations, is to shift from a “heads in beds” financial model, which allows the SNF flexibility from a revenue assessment model.

Tumlinson says that perspective gives control over care pathways within the network. The integrated system now focuses care resources on those more appropriate for the facility. 

What I enjoyed hearing most is that SNF's reach beyond the facility to serve patients and consumers wherever they live. The care focuses on the human and not on the institution.

Image credit: NIC Investment Center 

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