What If More Patients Were Sent Directly To Skilled Nursing Facilities?

Three health networks in Boston formed an accountable care organization (ACO) this year, the Beth Israel Lahey Performance Network (BILPN). This ACO sees an opportunity in sending patients directly to a skilled nursing facility (SNF) without requiring a three-day hospital stay.

BILPN’s three-day waiver program is meant to provide a path for patients who don’t necessarily meet the criteria to be admitted to the hospital but would benefit from care in a place better suited to address their needs.

For more on this please see the article below.

Home Health Becoming Most Likely Post-Acute Referral Destination

According to the 2019 Industry Trend Report from Trella Health, skilled nursing facility (SNF) admissions are dropping across the country while home health agencies have become the most likely post-acute referral destination.

Some states have seen a decline in SNF admissions anywhere between 14% and 26%.

For more on this, see the article below.

Hospitals Demand National Standards For Prior Authorizations

Hospitals are demanding national standards for prior authorizations regardless of which Payer they are working with.

Hospitals often believe they have followed the required steps and process flawlessly, only to discover their claim was denied. This inevitably leads to a painful and lengthy appeals process.

This article addresses the pain points many providers are feeling as well as suggestions to provide clarity to the prior authorization process.

New Rule Requires Hospitals To Provide Skilled Nursing Quality Data At Discharge

CMS has finalized a new rule requiring hospitals to give patients better visibility to their post-acute provider choices.
This rule will not impact the anti-steering regulations that prevent hospitals from recommending specific skilled nursing facilities, but rather enlighten the patient to make a more informed decision to their post-acute care while also considering their goals of care and treatment preferences.

For more on this, see the article below.

Michigan Number One In Cybercrime Complaints

Cyberattack prevention is more important than ever. The overwhelming majority of ransomware attacks are targeted towards small businesses that can’t afford to spend on defense. Companies have been found to pay up to four times as much to resolve an attack than they would have to prevent one.

As PHI is incredibly valuable, it will be more important than ever for SNFs to think defensively. This article details the major impact of cybercrime on businesses, Michigan in particular, being ranked number one in cybercrime complaints, and the nation’s top ten for victim losses in internet crimes.

See below for more on this. 

UnitedHealthcare’s 2020 Medicare Advantage Plans To Expand

With their 2020 nationwide expansion, 90% of Medicare beneficiaries will have access to a UnitedHealthcare Medicare Advantage plan.

Through our close relationship with UnitedHealthcare, we’ve brought contracts to multiple facilities recently. If working with UHC is of interest to you, connect with us to see how our strategy may be mutually beneficial.