NEW ORLEANS — Long-term care operators who may think that more complex health data gathering will be important only at the end of this decade, or that it can somehow be evaded altogether, are in for a rude awakening.
That was the cautionary message from a pair of health information technology experts and federal panel members Wednesday at a conference here.
“What is so important is that fee-for-service [payment] is quickly moving away. They’re moving the cheese, to this thing called ‘value-based payment,’ value-based care,” said Cynthia Morton, executive vice president of ADVION and a health information technology committee member within the Moving Forward Coalition. It is charged with helping implement recommendations from the 2022 NASEM report on improving nursing home quality
“Engagement is happening now,” Morton emphasized before speaking at the “Advancing Care Together” PointClickCare Summit conference Wednesday afternoon. “Providers have to educate themselves quickly to a whole new vocabulary. They had to learn all the ‘quality’ vocabulary and now they have to learn ‘risk.’”
She noted that a lot of sector talk has pointed to the Centers for Medicare & Medicaid Services’ goal of having all Medicare beneficiaries enrolled in some kind of value-based care pay model by 2030. That target is a real threat but also a red-herring, she pointed out.
“2030 is important, but it’s happening today. There are entities like hospitals, health plans and ACOs that want to engage with nursing homes to be part of their models now,” she said.
“Hospitals are doing scorecards, and have for years, but what’s different is, they’re saying, ‘We’re only going to refer to you if you share your data with us,’” added fellow committee member and speaker Bob Latz, CIO of Trinity Rehab Services. “[Providers] have to be having the discussions, are we ready to share our data? The hospital networks we’re in are already going to be saying we want to do this and we want you guys to sign this sheet, and give your data to us, and if you don’t do that, we’re going to maybe take you out of network.”
Risk losing market share
The competitive aspects are already real, Latz said.
“We heard about a provider group today that took its rehospitalization rate from 19.2% to 8%. If those two numbers get out there [in their market], every other provider better be thinking, ‘What can I do now, and not wait until 2030?’ This goes for all of us,” said Latz, who is also a certified physical therapist. “If their rehospitalization rate is 8% and I’m not doing some of this [data-gathering] stuff, [hospitals are] not going to refer to me, and I’m not going to be in business. That’s why it’s important for people to recognize this now.
“With people having more access to data, [the movement to data comparison] is coming whether you want it or not,” he added in an interview with McKnight’s Long-Term Care News. “If you don’t know your own data that’s being shared, you’re out of the game.”
Potential partners may already know it anyway, for better or worse. That point was made vividly clear earlier Wednesday by Kristin Thrun, a former nursing home administrator who related a past encounter with an accountable care organization that her organization was contemplating partnering with.
“They asked me for my patient data, and I didn’t know it. They [had it and] pushed it across the table like a stinky sock. I said I never want to be in that position again,” recalled Thrun, now the vice president of operations for Community Physicians.
The urge to delay improving data collection must be resisted, Morton emphasized.
“Others can get it and rate you and know you better than you know yourself,” she explained. “You’re not even going to know the ‘sock stinks’ because they’ll pass you by without saying anything.”
Latz estimated that just 20% to 30% of providers may now be ready to share patient data adequately with partners upstream and downstream. Morton said it might be a few points higher, but is still insufficient. Getting ahead of the pack is important, but it must be done right.
“Don’t panic — prepare,” she advised.
Guide will provide prep tips
Latz and Morton’s committee work should help providers around the country significantly. They are formulating a Nursing Home Health IT Readiness Guide for value-based care as members of The Moving Forward Coalition.
They said a rough draft should be ready later this year, with something more thorough to show by early next year. The guide will advise providers what they should have in place to better partake in the value-based care wave and the data sharing it demands.
The goal is that providers will be able to do a self-assessment based on an exhaustive line-item list. That will help them identify their own gaps to ascertain which IT tools they need to acquire.
The free guide will advise operators on transition of care best practices, data interoperability issues, and the creation of a patient/family portal to allow family members to see more up-to-date data on their loved ones. Getting hospital transfers with a paper folder of information on their chest isn’t going to cut it in the future, they pointed out.
“It’s something somebody can take a look and say, do we have this now, what value is there for putting it in place, and why do we need it, so it helps out with their strategic planning,” Latz noted. “The overall goal of the committee is to increase the use of health IT. If we can find ways to help people through those steps and that implementation and get it going, that’s what we want to do.”
Playing catch-up
LTC has admittedly been slow to adopt some tech best practices, but the sector also was left out of the incentive payments that hospitals and physicians received from the HITECH Act of 2009, Morton and Latz pointed out.
“We didn’t get the funding, so we’ve had to find our own ways to adopt,” Morton said. “We want to use this list of capabilities that are needed to show CMS and Congress, hey, you left our sector behind, yet we’re going to need to have these items in place for value-based care so we can partner with our hospitals.”
A bright light should be shined on the “unfairness,” they agreed.
“We’re being asked to collaborate with people who have received millions and millions of dollars and we’ve received nothing and yet are expected to collaborate at the same level,” Latz observed. “It’s kinda goofy to have that.”
