Andrei Gonzales, M.D. Change Healthcare’s director of value-based pay initiatives

Q: How are SNFs pursuing value?

A: Skilled nursing facilities that engage with physicians and acute-care hospitals are going to be more successful. Instead of just looking at what happens for that patient in skilled nursing, also understand where patients are coming from, where they’re  going and how providers are looking at services across the continuum of care.

Q: Any key learnings for skilled care from your recent payer survey?

A: The biggest takeaway is that providers are moving forward quickly in these models and there’s a clear indication that they’re growing at a rapid rate. The average cost savings reported is about 5.6%. None of them reported any increase in costs. I think the key is that these models are definitely here to stay.

Q: Does skilled nursing have a place in these value-based care models?

A: There are always patients who require care that is not appropriate for their homes, and that is not at the level they’d need in an acute-care hospital. That’s where skilled nursing or inpatient rehab comes in. For those settings, it’s important to understand when care is appropriate, and then they will be active members in these models. Unwarranted utilization is always going to be a problem because they are very effective at shining a light on excess utilization.