Surging Patient Demand and Declining Reimbursements Hit Struggling Post-acute …

  • Email a friend


It is going to take a willingness to adapt and commit to using technology to confront the challenges ahead, but post-acute organizations admit they are not prepared. They are still stuck in a volume-based care mindset.

Clearwater, FL (PRWEB) February 14, 2014

Black Book™ surveyed 464 providers of long term and post-acute care (nursing homes, hospitals, short term rehabilitation facilities, home health services, durable medical equipment/DME distributors, skilled nursing and sub acute facilities, and hospices) to help stakeholders of the post-acute provider industry identify strategic responses to address the higher growth/demand for post-acute services in the challenging environment of lower fee-for-service reimbursements and impending valued-based payment models from all payers: government and commercial.

Black Book’s annual post-acute IT user survey determines if there are more efficient ways to improve post-acute patient care while keeping providers accountable for improving quality and reducing costs through effective use of health care information technology. Specifically, the survey reported on health information exchanges (public and private), quality reporting, health analytics, workflow and care coordination, and patient engagement software/systems.

“It’s clear that the lines between payer and provider are blurring and the expectation is that post acture healthcare organizations must exist in a world of multiple payment scenarios,” said Doug Brown, President of Black Book’s parent, Brown-Wilson Group. “Yet, most long term care organizations are struggling to account for care, receive proper reimbursement, manage eligibility, proving medical necessity and institute strong reimbursement all of which are mandates as the financial environment evolves and reforms.“

“It is going to take a willingness to adapt and commit to using technology to confront the challenges ahead but post-acute organizations admit they are not prepared. They are still stuck in a volume-based care mindset,” said Brown.

“All healthcare organizations must find better ways to manage the patient transition into post-acute processes and keep hospital readmissions in check,” adds Brown. “The answer will require the expansion of technology capabilities to connect physician practices, home health agencies, hospices, outpatient settings, skilled nursing facilities, rehabilitation centers, DME firms, and hospitals.”

Black Book’s recently released “2014 State of the Healthcare Information Exchange Industry,” also revealed that it is essential that providers quickly evolve from a fragmented and siloed healthcare system to a more connected, patient centered ecosystem that requires connectivity between providers to build a continuum of care that is both clinically and financially informed.

“The future of connected and coordinated care means greater access, communications and interoperability, while preparing for new information sharing exchanges, post acuter administrators must also ready their organizations for the new reimbursement models focused on quality outcomes,” said Brown. “Integrating evidence-based practices through clinical operations can control rising cost, reduce duplications and other inefficiencies, and position the business to be a successful player in the post-acute continuum.”

Key findings of the Black Book 2014 Post Acute and Long Term Care Industry Information Technology survey include:

96 percent of all post-acute providers identified “declining reimbursements” as their most pressing issue of 2014, followed by payment denials, value-based accountable care models, and lack of care coordination.

Medicare and Medicaid (government) denials are more of a concern for 96 percent of all post-acute providers than commercial payer denials in 2014, particularly by home health and DME firms.

40 percent of hospitals, short term rehabilitation centers and skilled nursing facilities blame shifting government payer rules as the root cause of their denial issues.

88 percent of all post-acute providers forecast Medicare Advantage and/or Managed Medicaid and Medicare to force a significant shift in their payer mix by 2015.

67 percent of post care providers are unsure if the shift to a more managed care payer mix will mitigate the declining reimbursements of government payers. 15 percent do not think the managed care payer shift will mitigate the declining reimbursements of government payers.

63 percent of all post-acute providers report currently non-existent or extremely poor use of information systems, technology and patient data exchanges, including 79 percent of all nursing homes and skilled nursing facilities, and 73 percent of DME firms.

Despite 92 percent of post-acute providers confirming that information technology platforms for patient data sharing and comprehensive care coordination would improve their organizations’ financial health and ability to thrive under accountable care and lower fee-for-service reimbursement, 90 percent of all post-acute providers report minimal or underutilized technology currently across all settings.

88 percent of small chain (5 business units or less corporately) providers believe they have the capability to develop and implement strategies to succeed with information technology solutions, to support data exchanges needed for bundled payments, quality reporting and care coordination with the assistance of technology vendors and/or consultants. Only 5 percent have faith in their capability of such initiatives without external expertise.

89 percent of single or standalone nursing homes and skilled nursing facilities have no money budgeted for 2014 technology projects. 84 percent of large SNF and post-acute care providers have funds allocated this year for technology improvements.

About half of all post-acute providers forecast being acquired by a more technologically superior organization or corporation in 2015. Another 21 percent foresee bankruptcy, dissolution or closed services ahead.

88 percent of large chain post-acute providers plan on developing new products and services to confront the need for technology in their organizations.

56 percent of all post-acute providers anticipate participating in a public or private HIE to address lower fee-for-service reimbursements and accountable care reforms by the close of 2014.

To remain viable beyond 2015, 43 percent of post-acute CEOs anticipate engaging consultants and technology vendors to provider new strategies and solutions in 2014.

78 percent of all post-acute providers are unaware of any acute care technology or consultant organizations that specialize in long term care systems and solutions. 89 percent of aware of one vendor and/or consultant, or less.

52 percent of all post-acute providers predict up to 5 percent of their patient mix shifting to value-based reimbursement and accountable care models within the next twelve to thirty-six months. Over 60 percent of all DME and Home Health providers estimate a significant shift over 20 percent) of current patient mix to value-based models.

Black Book’s unbiased surveys, polls and vendor rankings are recognized as one of the nation’s top measurements of independent technology and services client experience in the healthcare industry. Uniquely based only on the responses of actual users, Black Book represents the market research polling results of 400,000 healthcare executives annually in over 30 product and managed service categories including Managed Care, Accountable Care, Electronic Health Records and Health Information Exchange.

A full gratis report is available at the Black Book Rankings report site, “2014 Long Term and Post-Acute Care Information Technology: Adoption, Utilization and Forecasts” at

Email a friend



Article source:

News Feed


Read more Protection Status