Hospital referrals are essential to the post-acute business model, and becoming more so. As the industry continues to evolve towards value-based care and bundled payments, hospitals “are being pushed to assume greater risk for care episodes [that] can extend well beyond the acute care discharge” and onto their post-acute care partners, as H&HN Magazine points out.
For this reason — and a few others —hospitals are becoming more selective with their referrals, and the nature of those referrals is changing, too. In a white paper on how post-acute care networks can increase their competitive advantage, researchers from Frost & Sullivan go into more detail about these reasons, including how:
- An aging population is fueling a need to care for more seniors
- A shortage of nurses is causing labor-pool difficulties in some regions
- Penalties for unsatisfactory hospital readmission rates are increasing
- The rise of the bundled payments model is causing hospitals to more carefully assess post-acute care referrals
- The ongoing consolidation of hospital and physician groups is reducing the number of overall referring partners available to post-acute networks
- The shift of lower-acuity treatment to the home is creating more need for (and referrals for) high-acuity treatment in post-acute settings
In short, conclude the authors, “post-acute facilities have fewer referral sources than in the past, meaning that maintaining strong relationships with each one is critical” — before going on to explain precisely how that can be done via contact-free continuous monitoring (CFCM) technology.
How Contact-Free Continuous Monitoring Can Help Preserve Hospital Referrals
The key for a post-acute care network to preserve important relationships with referring hospitals lies in its ability to treat more high-acuity patients, argue the white paper authors — and this can be done with the implementation of contact-free continuous monitoring in just a fraction of its patient beds.
“The addition of CFCM allows facilities to take on a significantly higher number of more complex patients, which the facility may not have been able to manage in the past,” the authors note, detailing that this is possible because it “helps these providers align some of their most important outcomes metrics with referring hospitals and physicians,” including:
- Improving readmission rates
- Enabling earlier intervention for cardiac events
- Reducing patient falls
- Preventing the onset of sepsis
- Improving patient satisfaction scores
- Reducing the prevalence of pressure ulcers and bed sores
- Maximizing the efficiency of a facility’s current workforce
The technology’s ease of use is also an important factor in its ability to maximize efficiency and improve patient care. As Dr. Zachary Palace, Medical Director of Hebrew Home and an early adopter of CFCM, told the authors, the technology represents “a ‘plug-and-play’ solution to increasing quality and safety by increasing Five-Star ratings, and reducing sepsis and infections.”
Contact-free continuous monitoring technology “allows us to bring in higher-paying patients and gives us marketing advantages to referring physicians, especially related to reducing 30-day readmission CMS penalties,” Dr. Palace added. “We have a better ability to keep our census high, which is so important when cash pressures are as intense as they are in post-acute care.”
The Impact of Bundled Payments on Hospital Referrals for Post-Acute Care Networks
Bundled payments are also having an impact on hospital referrals, the authors note. Even though most post-acute care networks are not directly included in the bundled payments model, the hospitals that refer patients to them increasingly are. Therefore, administrators at hospitals and health networks are more closely scrutinizing the performance of the post-acute care facilities in their referral networks.
Contact-free continuous monitoring can help facilities meet this heightened level of scrutiny, particularly skilled nursing facilities, which “are likely never going to be state of the art,” as another administrator told the white paper authors. “CFCM gives SNFs the ability to go to a hospital with very reliable data to show your improvement in readmission rates and share data with that hospital,” he adds.
Failure to improve and document performance “can put post-acute facilities lower on the referral list that hospitals share with patient families during discharge planning,” the authors note.
On the other hand, facilities “can expect to see an increase in the number of their patients reimbursed under bundled payments, especially those with heart failure or who recently underwent joint replacement and spinal surgery,” and can prosper by configuring just a fraction of its number of beds to treat these higher-acuity patients.
Treating High-Acuity Patients Could Increase Hospital Referrals (and Post-Acute Revenue)
This expanded capacity to treat higher-acuity patients not only enhances a post-acute care network’s potential to retain — and increase — hospital referrals, but it can also serve as a powerful tool in boosting a facility’s bottom line in a particularly competitive market, the authors note.
Medically complex patients are “estimated to bill at a 63% higher rate and have a 75% longer LOS than non-medically complex patients,” they point out. “So, while the actual number of patients cared for by the facility decreases in the model, the occupancy rate of the facility and the average daily payment across all patients would both be expected to increase.”
Using an evidence-based model, the authors estimate that a typical, 106-bed post-acute facility that deploys CFCM technology to 21 medically complex patient beds has the potential to:
- Increase revenue by 22%
- Grow net profit margin by 12.8%
- Decrease readmissions by 20%
That last point is, of course, key to “helping the facility retain reimbursement that it would have lost otherwise” — as well as landing new hospital referral partners. “Referring hospitals and physicians will drive their complex patients to the facility since its adoption of CFCM demonstrates it is best in class,” they add.
“Reducing unnecessary readmissions is a key priority for hospital partners and many now make their referral decisions based on rates of readmission,” the authors conclude. Reducing those readmission rates — and improving overall outcomes and documentation thereof — are essential for preserving hospital referrals and increasing a facility’s patient base, as “the percentage of patients discharged from hospitals for rehabilitation at sub-acute care facilities is likely to grow.”
Learn more about how contact-free continuous monitoring can help your post-acute or skilled nursing facility preserve and increase hospital referrals: Download the complimentary white paper here, or contact us here to schedule a consultation with an EarlySense expert.