Skilled-nursing facilities feel the pinch from fewer inpatient stays
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Efforts to reduce hospitalizations among Medicare beneficiaries have sparked a steady decline in admissions over the past several years and have also hit the bottom lines of many skilled-nursing facilities.
A new analysis released Thursday by Avalere Health found that Medicare beneficiaries have spent 15% fewer days in SNFs between 2009 and 2016. Medicare fee-for-service claims fell from 1,808 days per 1,000 beneficiaries to 1,539 days per 1,000 over that period. Hospitals in recent years have shifted toward referring patients to home healthcare services instead of SNFs, in an effort to promote value-based care over fee-for-service models as well as improve patient satisfaction. But Avalere found the rise of home healthcare was not the main driver for the decline in SNF use between 2009 and 2016. It had to do more with hospitals increasingly placing patients in observation status over admitting them for inpatient services. Under CMS rules, Medicare covers up to 100 days of care at a SNF, but patients must have received at least three days of hospital inpatient care before they can qualify for coverage at a nursing facility. Patients placed in observation are not eligible to stay at a SNF after they are discharged. Per capita hospital discharges fell by 17% between 2009 and 2016 fell by 17% while the number observation stays increased, according to the analysis.Send us a letter
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