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Senior Housing > Blog > 2016 > July

An Update on CMS’ Bundled Payment Plans

If you work in senior housing in any capacity, chances are you’ve been keeping a close eye on CMS’ (Centers for Medicare & Medicaid Services) proposed payment bundle. If approved, the new payment plan would go into effect next summer. Here is a brief look at the proposal and what some of the changes may look like:

  • The payment bundle would impact patients who suffer a heart attack or who are in need of bypass surgery
  • Nearly 100 hospitals in metropolitan areas would be affected
  • The new plan would cover first cardiac procedures and the second set of medical treatments needed

The idea behind this proposal is to give providers incentive and to cut costs overall. At present day, the U.S. healthcare system is making an effort to shift towards a value-based payment system that is designed to reward doctors, hospitals, and other medical caregivers for care that reaches above and beyond. This proposal by CMS is in-line with other such plans, all of which encourage medical providers to focus on quality over quantity of care.

In addition to cardiac patients, the bundled payment model would include hip and femur fractures. A similar plan was proposed and implemented in July 2015 for hip and knee replacements, known as the Comprehensive Care for Joint Replacement model. Today more than 800 hospitals in 67 metro areas in the U.S. are affected by this model.

Beyond changing the way in which hospitals and doctors will be reimbursed for cardiac procedures, this proposal also encourages cardiac rehabilitation in an effort to cut down on the number of return patients hospitals see each year. Under the current model, in 2014 alone hospitalizations for heart attacks alone cost Medicare more than $6 billion, and that was for just 200,000 beneficiaries.

This specific bundled payment plan and other similar plans are hoping to encourage change in our delivery system and ensure that patients receive the care and attention they deserve, while also working to improve their overall health. For more information on this plan and how it will affect skilled nursing facilities (SNFs), please do not hesitate to contact Shep Roylance of The JCH Senior Housing Group today.

Hospital Admission Rates Lower than Ever for SNF Residents

If you are in the senior living industry in any capacity, you are likely aware about the ‘revolving door’ of rehospitalization from skilled nursing facilities (SNFs). Unfortunately, it is not uncommon for SNF residents to find themselves in the emergency room or as a hospital patient in some other capacity. However, the tide may be changing. According to a report from the Commonwealth Fund, there has been a widespread reduction in the length of hospitalization for nursing home residents, as well as an improved readmission rate. It should also be noted that nursing home quality across the board has improved, which is due to numerous factors, including:

  • Policy changes
  • Improved staff stability
  • Safety reducing hospitalizations
  • Better decision-making and training

These are just a few of the factors that have had a direct impact on the overall quality rating of nursing homes. Keep in mind there are many other areas that have been a focus for nursing home management teams, some of which are very specific to that particular facility.

Why Quality Matters

When looking at this change in hospital admission rates among SNF residents, we cannot deny that quality control hasn’t had a major impact. As with any industry, product, or service, quality defines success. When it comes to nursing homes and hospital admission rates, specifically, we must look at quality and why it matters. These days hospitals are chomping at the bit to collaborate with nursing homes to smooth the discharge process, for one, and this has had a major impact on how the two entities work together to keep patients as healthy and comfortable as possible.

Nursing homes are currently working to standardize protocols and implement solid long-term care plans in order to appease hospitals and get residents the care and attention they need. While hospital trustees have always said that quality of care is important in their institutions, the role of nursing homes in this was never really recognized – until now. Today, hospitals understand that they need to work closely with SNFs in order to improve patient care, control costs, and keep readmission rates low.

Report: Nursing Home Residents Getting Younger

A new report indicates a rather surprising trend hitting nursing homes across America – young people are making up a portion of nursing home population. While in the past the majority of people who went into nursing homes or other skilled nursing facilities (SNFs) were very old and could no longer care for themselves, this is no longer the case. In fact, the Department of Health and Human Services has uncovered that young people between the ages of 31 and 64 currently make up 14% of the senior housing population. Furthermore, the National Center for Health Statistics indicates that young people with disabilities and adults between the ages of 65 and 74 who live in nursing homes has grown from 13% of all residents to nearly 15%.

There are numerous reasons for these changes – whether people are opting to live in nursing homes for short-term stays or because the overall landscape of nursing homes is changing, making them far more attractive to people of all different ages and ailments. In recent years, SNFs have worked hard to cater to short-term residents, in large part because of Medicare changes. As mentioned above, young adults with disabilities are also a growing nursing home population, which also has to do with insurance issues as well as the level of care that is now being offered through many assisted living facilities.

What is Different?

Whether talking about young seniors or disabled young adults, nursing homes are becoming an increasingly attractive option. Some are requiring care at a younger age due to a stroke, MS, or other health ailment, whereas others are entering nursing homes because it is easier on their loved ones. Regardless of the reason, SNFs across the country are making adjustments in order to cater to this new population. With the introduction of technology and a very different generation overall, nursing homes are quite different than how past generations experienced them. If you ask many senior housing operators, what used to be important or the ‘norm’ for residents is no longer the case. Nursing homes are discovering that they must offer a variety to their residents – whether that means access to technology and WiFi or yoga classes. Gone are the days of nursing home residents sitting around in their ‘house clothes’ watching soap operas, today’s younger residents want to stay in touch with the outside world through trendy activities, Wii bowling, and music. In order for SNFs to not fall behind, it is important to pay attention to these changing numbers and the new demographics entering nursing homes, and adjust accordingly.