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As the post-acute care industry continues transitioning towards a value-based care system, skilled nursing facilities (SNFs) should start to consider participating in an Accountable Care Organization (ACO) to not only help in achieving optimal outcomes but improving patient care journeys uniformly. Building a clinically robust continuum of care includes long-term acute and post-acute care hospitals and providers collaborating effectively. Even though only a small percentage of patients require care in post-acute settings, this number is growing, with the volume of referrals to skilled nursing facilities (SNFs) having grown more than 10% in the last two years. These patients also often require the most complex and costly care, accounting for nearly $60 billion of annual Medicare spend, putting them at a higher risk for readmission, as they often suffer from multiple chronic conditions and have the greatest need to be treated by practitioners and specialists on an ongoing basis.
Accountable care organizations are designed to put patients at the center of care to help them navigate a complex health system – particularly receiving extra help managing chronic diseases. These coordinated care efforts put forth by ACOs help ensure chronically ill patients get the right care at the right time, with the goal of avoiding unnecessary duplication of services, avoiding hospital readmission and worsening of conditions, and preventing medical errors. ACOs also place financial responsibility on providers in hopes of improving patient management and decreasing unnecessary expenditures, all with the patient and their journey at the forefront of these efforts.
But SNFs have been reluctant to participate in ACOs. According to a whitepaper published by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) and the National Association of ACOs (NAACOS), less than 2,000 SNFs actively participate in ACOs, which is about 10 percent of SNFs in active operation nationwide. Even then, this percentage is concentrated in a small amount of ACO’s leaving 70% of them to have no SNF representation. A national ACO survey revealed that over half of ACOs had no formal relationship with SNFs, yet the majority of ACOs are forming preferred SNF networks to improve collaboration between patients, providers, and facility staff, as well as to address the increase and variation in healthcare spending on this area.