Have ACOs been a disaster for SNFs?
Some SNF leaders think so, regarding ACOs as a disruptor that wrecked their way of doing business and providing the best patient care.
In a 2019 interview with Skilled Nursing News, an anonymous SNF operator blasts the ACO model as unfair and damaging to SNFs. He says ACOs marginalize SNFs, not giving them a “strong seat at the table.” He suggests that ACOs focused on cost reduction either cut SNFs out of the care plan or send only patients requiring shorter stays. He also strongly disputes that ACOs are even improving patient outcomes or reducing hospital readmissions.
“ACOs have turned out to be from the perspective of the SNF provider a complete, utter failure,” he concluded.
The Positive ACO Potential for SNFs
While that’s an extreme negative perspective, there is an alternative, much more optimistic outlook for SNF-ACO relationships. Some ACOs have made post-acute care and SNFs partnerships a focus of their success, with more collaboration and positive results. Research also indicates that ACO-participating hospitals discharge more patients to SNFs with better quality performance than their non-ACO counterparts—ACOs are rewarding the SNFs providing the best care.
The long-term care ACO launched by SNF market share leader Genesis showed early significant shared savings returns of $18.8 million in 2019, with observers interested in seeing performance as they expanded their network beyond their own facilities during tough times in 2020. Other observers expected more SNFs to dive into ACO participation and leadership in 2020, although the COVID pandemic distracted or stalled many such plans.
Despite initial bumps and uncertainties, SNFs remain highly interested in understanding how to best participate in ACOs and care networks. We at Trella Health noted the significant number of SNF attendees for our recent webinar “Building a Winning Network: Key Insights and Implications for ACOs.” SNFs are thinking hard about their ACO strategies, with many considering them as a potential key to survival for emerging successfully post-pandemic.
Assess and Impress: An ACO Approach for SNFs
SNFs have had ups and downs in their relationships with ACOs. Even as ACO strategies change and participation by providers may ebb and flow, the broader focus on managed care across the continuum will remain. SNFs must compete and thrive in world of ACOs and integrated networks, forging partnerships and collaborating on care and outcomes with the providers in their communities to succeed.
So how can SNFs best prepare and align themselves for productive collaboration with providers in managed care and ACOs? All SNFs should consider building their ACO and network strategies around the concept of “assess and impress.”
First, they must assess the ACOs and network providers they will consider as partners. SNFs need to be able to see the most current, complete, accurate outcome and performance data for networks and providers to be confident that their commitments will pay off in shared savings or minimized risk.
They can also take control of their own data to impress top networks, hospitals, practices, and providers. For example, many hospitals look to CMS 5-Star Quality ratings and Nursing Home Compare to grade SNFs—sources SNFs have long lamented as inaccurate reflections of their performance in patient care quality and experience. More SNFs are collecting their own data and making their cases directly to convince practices and hospitals to refer more patients to them. Many SNFs are also providing those provider partners with data updates to continuously reassure them that they are providing the best patient outcomes and opportunities for shared-cost savings.
Trella Health provides industry-leading data solutions and insight for SNFs to navigate their ACO and integrated network options and strategies with total confidence and competitive advantage. Contact Trella to learn more about connecting with the ACO data that empowers your SNFs.