The post-acute care landscape is going through a significant shift. More and more patients are opting to receive post-acute care at home over that offered in institutional settings like skilled nursing facilities (SNFs). Many factors, like the COVID-19 pandemic and affordability, have led to this shift.
When adapting to this changing landscape, clinicians must be aware of these factors to maintain their quality of care and financial stability.
In this article, you will discover what led to this shift, the challenges it poses, and the policy changes that may help you as a clinician sustain in a competitive market. You will also learn what the future of home-based post-acute care looks like and how ChartPath can help you navigate it.
The next step after a patient recovers from a serious illness or receives a medical procedure is post-acute care, which can help the patient transition back to their daily life. Such care must be implemented with the assistance of a clinician.
The model used to deliver the care, however, may vary, and the two primary post-acute care delivery models are:
After discharge from the hospital, your patient will need help deciding between opting for post-acute care at an SNF and receiving it in an at-home setting. When doing so, you and the patient will need to consider various factors to choose the environment most conducive to your patient’s health and condition. These factors keep changing and evolving regularly, and keeping an eye on those will help you make the best decision for your patients.
Since the COVID-19 pandemic, the number of post-acute admissions at SNFs has decreased greatly, but that of HHA users has gone up. Specifically, a National Institute of Aging study found monthly SNF admissions decreased by 19,000 compared with those before the pandemic, whereas monthly users of HHAs increased by 30,000 — the exact numbers may vary by the demographic and state, though.
The main reasons for this shift range from patients’ personal preferences to regulatory and social shifts.
Though an SNF can provide better care and faster access to services, many patients just prefer to receive care and aging in place from the comfort of their own homes. They believe that with home-based post-acute care, they will be in a more comfortable environment than in an SNF during recovery.
Home-based post-acute care tends to be more cost-effective than care in an institutional setting. Medicare reforms in reimbursement models, like the Patient-Driven Payment Model for SNFs and the Patient-Driven Groupings Model for HHAs, have incentivized the shift toward home-based post-acute care, which has made facility-based care options less affordable.
Infections such as COVID-19 are more likely to spread in congregated settings like SNFs than in private settings like a patient’s home. Researchers have found that care in a home environment leads to lower infection transmission rates and superior patient health outcomes.
The shift away from institutional post-acute care toward home-based delivery models can lead to better health outcomes and more cost-effective, patient-centric care. Yet, clinicians face a number of challenges when navigating this shift. Here are the three main challenges.
Despite their drawbacks, SNFs provide a centralized location where clinicians can continually monitor the health status of their patients and assess them for any preexisting or new conditions. Without consistent access to clinicians, some patients under home-based post-acute care may not receive the monitoring they need to recover from their condition completely.
The healthcare industry is already faced with challenges like significant workforce shortages and an aging labor population. SNFs provide a comprehensive environment for the delivery of patient care, and it’s unclear whether the increase in HHA use will place excessive strain on HHA resources.
With more and more patients receiving post-acute care at home, the potential of them receiving care from different clinicians who are less familiar with their health status is greater than ever. Maintaining continuity of care can be difficult for patients under home-based post-acute, so implementing an effective monitoring method is a must.
You can address these challenges using a number of solutions, the main one being the efficient use of technology. For example, you can integrate electronic health records (EHRs) across multiple organizations to ensure improved continuity of care when your home-based patient visits a new clinician. EHR solutions also possess telehealth and other remote monitoring functionalities, improving your ability to monitor and diagnose patients virtually.
Policy changes, the COVID-19 pandemic, and innovations in technology have all contributed to the shift from SNFs toward home-based post-acute care. While the amount of required care, as well as accessibility, can impact patient and caregiver preferences to some degree, home-based care models are favored across nearly all demographics.
Though challenges such as workforce shortages and care coordination can be a hurdle to maintaining profitability and delivering quality care, technological solutions such as telehealth and remote monitoring can help resolve those issues.