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Hospitals push home care over skilled nursing thanks to bundled payments

August 7, 2018
by I Advance Senior Care
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Hospitals that participated in Medicare’s bundled-payment initiatives were particularly focused on getting patients home first and foremost, rather than sending them to skilled nursing facilities, according to a new study published in Health Affairs.

That came as a surprise to the researchers, Jane Zhu of the Perelman School of Medicine at the University of Pennsylvania told Skilled Nursing News. She described hospitals’ focus on sending patients home as “a dominant strategy in response to bundled payment participation.”

The research focused on 22 hospitals that participated in lower joint replacement episodes within the Bundled Payments for Care Improvement (BPCI) program and the Comprehensive Care for Joint Replacement model, initiatives designed to improve quality and reduce Medicare costs by reimbursing providers for a single “episode” of care. Forced to share a finite amount of money for the episode, providers across the spectrum are expected to work together to bolster care and prevent cost overruns, such as avoidable rehospitalizations.

While the study did note the shift toward home-based care, the researchers also found that hospitals actively tried to improve coordination for patients who were discharged to SNFs.  Their primary strategy was setting preferred networks, defined by Zhu as organized efforts to coordinate care and discharge patients to a select number of SNFs. Fifteen of the hospitals and health systems in the study had formed networks of preferred SNFs.

This could be done formally, with contracts, or with more informal referral-based arrangements, Zhu said.

Read the full story at Skilled Nursing News.

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