President Barack Obama’s reelection ensured that the Affordable Care Act (ACA) will be fully implemented and your organization needs to be prepared for its potential impact on your facility or service. Here are some important aspects of the law you must consider when making strategic and tactical decisions that will impact the marketing of your services.
1. The ACA will reward high-quality service providers.
There are provisions under the law whereby Medicare-certified providers of skilled nursing care, home healthcare and hospital services will be compensated for meeting patient satisfaction survey standards. Also, hospitals are beginning to evaluate quality indicators as a factor in making referring decisions. In certain markets nursing home providers have been excluded from preferred provider networks because they failed to meet minimum Medicare 5-Star Ratings, quality indicators and hospital readmission rates.
Plan: Develop resident/client satisfaction survey programs that evaluate the categories of satisfaction outlined in ACA. Improve quality indicators. Create strategic alliances and other programs and services that reduce readmissions.
2. Medicare cuts will result in patients shifting to different levels of care.
Medicare’s history of cuts to services has resulted in patients being served by different levels of care. For example, in the early ’90s hip and knee replacements were shifted from acute rehab to sub-acute rehab in skilled nursing facilities. Your organization must be prepared to serve patients with high acuity levels previously served in other care settings.
Plan: Develop programs and services which meet the advanced clinical and functional needs of patients.
3. Accountable Care Organizations will be developed.
ACOs are beginning to crop up in various markets. Hospitals are beginning to create preferred provider networks of post-acute services. Even assisted living and private-duty home care agencies are being targeted by hospitals for preferred provider relationships. SNFs early experiences with ACOs suggests that reimbursement and length of stay will fall much like they did with the development of Medicare Replacement Plans. You must be meeting with CEOs and other executives in hospitals and large physician groups to ensure your facility/service is included when these are created.
Plan: Schedule meetings with CEOs of hospitals to discuss their plans for developing ACOs and preferred provider relationships. Develop preferred provider relationships with various providers of services to more fully meet the needs of your residents or clients.
This is going to be an interesting time for the healthcare industry. Adaptation will be critical for your organization’s success as will solid business practices as the costs of providing healthcare for our employees will also negatively impact the bottom line.