McKnight’s One on One: Improving Outcomes Through Value-Based Care
Originally published by McKnight’s on October 19, 2023.
As staffing constraints and mounting regulations continue to challenge nursing homes nationwide, it is imperative for care providers to develop innovative strategies in adopting value-based care initiatives that will improve facility performance, occupancy and revenues.
During a recent webinar, McKnight’s Long-Term Care News Executive Editor James M. Berklan sat down with Scott Rifkin, MD, founder and executive chairman of Real Time Medical Systems (Real Time), to discuss the various types of value-based care payment models available and proven strategies that enable facilities to demonstrate value as high-performing providers for their hospital and health plan partners.
The value-based care payment model
Previously, the payment system model incentivized providers by “increasing length of stay, having people go to the hospital and come back as Medicare patients, and it hasn’t been good for the healthcare industry,” Rifkin explained. In contrast, value-based care “incentivizes good patient outcomes, quality of care, and keeping people healthy and out of the hospital.”
In addition to improving patient care and outcomes, the adoption of a value-based care mindset has many
benefits for skilled nursing operators.
“It opens up a whole new revenue stream if we can share in the savings created by reducing hospitalizations and keeping people healthier,” Rifkin said. “It’s a tremendous opportunity if we can change the way we think about providing care and nursing.”
While value-based care payment models pertain to both short-stay and long-term care patients, there are tremendous opportunities to work with insurers among the short-stay patient population, Rifkin said. While as the owner and operator of Mid-Atlantic Health Care LLC (MAHC), Rifkin partnered with a large insurer in Philadelphia to reduce the typical hospital stay of 23 days. The company handled its own case management, discharge planning and social work efforts and received the full Medicare rate for only 15 days. The result: “The actual length of stay was 10.8 days, the return to hospital rate was lower from the nursing home, and we dropped our readmission rates for short-stay patients from 20% to 22% down to 8% to 10%,” he noted.
