Survey says ... healthcare reform gradually coming into focus for long-term care providers

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James M. Berklan, McKnight's Editor
James M. Berklan, McKnight's Editor

For those who think that long-term care providers aren't sitting up and taking sufficient notice of healthcare reform changes on the way, I say take another think. Providers know they're in for change — they just don't really know what to do about all of it yet.

Long-term care operators clearly deserve credit for not sticking their heads in the sand, for the most part. That's what first struck me while serving recently on a panel that had about 500 providers instantaneously texting in answers to our questions.

Four-fifths of the group (80%) said that healthcare reform initiatives would likely impact their businesses “significantly” in 2014. Another 19% answered “moderately.” The others? Maybe they were more intent on enjoying the delicious cookies at the American HealthTech symposium in Jackson, MS, where this was taking place.

The crowd felt even stronger about the importance of having closer relationships with hospitals/physicians in the near future. While 6% said such relationships would “not make much of a difference,” and 1% predicted a negative impact, 93% said closer relationships would have “significant financial/clinical benefits.”

The survey was taken soon after the incredibly erudite Guy Masters of the Camden Group described the ins and outs of accountable care organizations. He already works with doc practices and coordinated care efforts so his words were not merely policy or theoretical talk.

Another group question started to reveal signs of something that long-term care operators as a group undoubtedly will need to work on. Had there been any meetings to discuss partnering with a local hospital(s)? More than half (55%) said yes and another 10% said “in the next six to 12 months. But 35% flat-out said no. That final number has to shrink.

A look at the providers' average hospital readmission rates also was eye-opening. More than a quarter (26%) said they were at an outstanding rate of less than 10%. The biggest group was the 10% to 20% range, which garnered 43% of the respondents. That's a broad category, though — probably too broad. It would be interesting to see how things fell with regard to a 15% demarcation line.

Again, extreme candor was evident among the crowd, as 9% admitted to being in the 20% to 30% readmission range, 3% said they had (gulp!) more than 30%, and 19% admitted they didn't know their rate. One can only hope that the 20%-and-above rates are brought significantly lower, and there should be a virtual guarantee that the next time a survey like this is taken the “don't know” respondents will come in at a much lower rate, if not zero.

If there's one thing that has become blatantly obvious in recent months and years, it's this: The provider that doesn't measure, control and reduce its hospital readmission rates, is a provider asking for big trouble. Those providers risk being ignored by providers up and down the line, and being left at the brink of obsolescence.

Another question that drew strong interest in the brief survey inquired about the providers' “greatest challenge” in today's market.

Finding enough skilled staff to manage higher acuity was the No. 1 pick, with 46% of the vote. Next came “increasing Medicare census” (38%), “interoperability with partners” (11%) and “other” (3%).

Trailing was “responding to hospital demands” (1%), which could see a dramatic uptick in future surveys, if many experts' predictions about the hierarchy of accountable care organizations come true.

On one hand, it was heartening to see that providers seem to be engaged and have their antennae up when it comes to healthcare reform. Indications also were, however, that there's still plenty of fine-tuning to be done.

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.