Long-Term Care

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Long-Term Care

Just in case you haven’t heard yet, the Patient Driven Payment Model, more commonly referred to as PDPM, is coming into effect this year! And although a large part of this new reimbursement model is related to coding changes and staff re-training, there’s a piece of this puzzle that hasn’t gotten much limelight—data collection.

With today’s data and technologies, we’ve started to see more and more skilled nursing facilities becoming smarter communities that can not only proactively care for residents but begin to predict illnesses before they happen. And just like their acute counterparts, they are utilizing interoperability tools to digitally exchange data with others and may even be using predictive analytics platforms to decipher through decisions at the point of care. However, the long-term care (LTC) industry is a little behind in full adoption of this technology. In fact, a Black Book study mentions that only three percent of LTC organization respondents to their poll are able to engage in the data-driven competencies that underpin value-based care

Here are a few examples of how LTC facilities can benefit from acquiring and implementing advanced data analytics:

  • Use claims to conduct internal and external auditing.
  • Clinicians can make informed decisions at point of care.
  • Create insightful reports to demonstrate value to referral hospitals, or to merger and acquisition candidates.
  • Triage clinical efforts to the highest at-risk population (re-hospitalizations; falls; etc.).

The implications for PDPM

Clinicians and administrators will need to use data to support their decisions, whether through outcome reports or decision support tools. Usually evaluations based on research produce the best outcomes and provide a better resident experience. In fact, with PDPM, CMS has taken a big step away from paying for quantity of care and has simultaneously started tracking, measuring, and rewarding quality outcomes. PDPM cannot just be about coding, but rather a united strategy for resident success, making sure that skilled nursing clinicians are providing the appropriate care depending on the clinical complexities of the resident.