Long-term care (LTC) is undergoing major changes sure to impact all LTC providers. These changes are occurring as a result of a focus to decrease LTC costs, which are expected to occur through reductions in both LTC utilization as well as reimbursement. These cuts are occurring not directly through Medicare and Medicaid but through private payers, such as managed care organizations and other groups newly responsible for LTC services.
Skilled nursing facilities (SNFs) and other LTC facilities succeeding in the face of these regulatory and practice shifts will be those that understand these changes and have developed processes to efficiently and effectively deliver care under these new rules, especially regarding a reduction in the use of emergency and hospital services for SNF residents. Specifically, this will require SNFs to deliver outcomes for which they are being held accountable. In addition, SNFs will need an enhanced focus on medication management because of several regulatory and environmental changes in this area.
Success in this new world will only come to those LTC providers who understand these changes and are prepared to act. This article briefly reviews bundled payment changes, Accountable Care Organizations (ACOs), managed Medicaid, pay-for-performance requirements, and the increased complexity of medication management. Read More
