The federal government dropped new data into the Nursing Home Compare consumer-focused website on Wednesday, giving facilities their first real chance to see how they measure up against their peers across the country.
The data also revealed that, despite a heavy emphasis on lowering rehospitalization rates in recent years, the overall SNF rehospitalization rate rose from 19% in 2015 to 19.4% in 2017.
The newly released information is tied to the SNF Value-Based Purchasing Program. Of the nearly 15,000 facilities taking part, about 27% received a bonus while the other 73% were penalized. The penalties went into effect on Oct. 1 and were based on data from 2015 to 2017.
Up to this date, SNFs had been aware only of their individual scores. Now they have the chance to measure themselves better against peers and competitors.
SNF leaders will want to check their individual rankings because many payers will be curious about this information, Amy Stewart, RN, curriculum development specialist with the American Association of Directors of Nursing Services, told McKnight’s on Wednesday. She added that the field already is aware of how an individual facility manages readmissions and whether it’s receiving an incentive payment, but this new release allows consumers and stakeholders, such as accountable care organizations, to see how SNFs compare.
“This could increase competition among nursing homes in a geographical area,” Stewart told McKnight’s. “If I was an ACO, I would be checking the ranking of my ‘partners’ to see which ones are hitting the mark, and which are not.”
One eye-opener from the data is that in 2015, the SNF rehospitalization rate sat at about 19%, while in the new 2017 data released today, the average actually had risen to 19.4%.
“This is a surprise, since typically when you measure something and tie payment to it, it improves,” Thomas Martin, director of post-acute care analytics at CarePort Health, told McKnight’s. “Keep in mind that the data is almost a year old at this point, and significant lag time may dampen improvement.”
The data represent a subset of the population that SNFs treat, coming from Medicare fee-for-service claims only. Martin said that as Medicare Advantage popularity continues to swell, this measure will represent an increasingly shrinking portion of the SNF resident population.
He noted that the range of payment multipliers went from providers losing 2% up to an increase of 1.6%. Just less than 3% of providers scored 100 points and got the maximum 1.6% payment, while about 20% of providers scored zero points in the program, earning the maximum penalty and losing the entire 2%.
Stewart noted that the data is old, measuring improvements from 2015 to 2017, and said she believes that many facilities may have improved greatly since then. She urged SNF leaders to scrutinize each individual transfer to the hospital and perform root cause analyses to determine why the move was necessary.
“In the end, we can’t change old data but we can put interventions in place today to help improve future numbers and we can let our referral sources know about our current readmission numbers and our strategic plan for continued improvement,” she said.