In the next 10 years, the skilled nursing industry will essentially contribute $14.6 billion to healthcare reform in the form of Medicare cuts, says Paul Bach, executive vice president at Genesis HealthCare.
"While the industry wants to participate with other healthcare provider groups with the reform, at the same time, we're concerned with the viability of the industry, coupled with other factors," he
says, citing frozen Medicaid rates as an example.
"For smaller operators, they're under the same pressure large, multi-location facilities are under, and there's a need for them to be progressive and proactive in how they plan to respond to what's in the ACA," says Bach
There's a trend in skilled nursing to diversify businesses that primarily offer traditional models of long-term care nursing homes to include a larger focus on short-term care services, according to Paul Bach, executive vice president at Genesis HealthCare and president of the company's Central Area, encompassing Eastern Pennsylvania and all of New Jersey.
recently introduced its "PowerBack" model of short-term skilled nursing and rehabilitative care, citing a need in the market for a more efficient type of nursing facility that focuses on getting patients back into the home as quickly as possible rather than a nursing home that lumps all patients together, regardless of varying needs or acuity level.
"We think in the future that CMS will want to reimburse for care based on what the patient needs, and not necessarily the type of care the facility delivers," says Bach
Working with consulting firms to build a financial model along with a brand identify for the new PowerBack product validated Genesis' belief-and research-that the market was ripe for this model of care.
A typical nursing home serves short-term and long-term residents under the same roof, Bach
says, but those are often very different populations.
"We think that model is becoming outdated," he
says, adding that people in need of just a couple weeks of post-acute rehabilitative care don't necessarily want to be in the same environment as someone who has dementia or other long-term care needs.
"We're creating a model for both, [but] in separate buildings.
We think that's what the market is calling for."
In the PowerBack model, the intensity of therapy and medical services is enhanced, Bach
says, allowing patients to "float through" the rehab process much quicker.
The program also focuses on educating patients after discharge and following up with them regarding appropriate post-acute care.
As hospitals and health plans begin to narrow their networks of skilled nursing facilities to which they refer patients, they will only discharge to facilities that have the best outcomes in terms of readmissions, says the Genesis executive.
"The facility model that we've developed fits squarely into the middle of that strategy."
has existing partners in the acute care health system and health plan sectors, but now the company is getting "a lot of attention" from both hospitals and health plans regarding this short-stay model, according to Bach
The idea is to create an environment that is medical-intensive, but overlaid with higher-end hospitality services and amenities, Bach
But while Bach
says this diversification of services will become a trend, it won't necessarily be possible for all skilled nursing providers.
"The key is, it has to be organizations that have the capability to deliver higher-end rehabilitative care and the higher-end medical care," he
owns and operates its own national rehab company, Genesis Rehabilitation Services, and has its own physician organization.
"Not all of our peers have those types of capabilities; that's really a key of success."
Ultimately, as healthcare reform seeks to improve care quality while saving money, skilled nursing is bound to play an important role.
"There's a lot of attention being paid to the rehospitalization rate of patients flowing out of the hospital into skilled nursing facilities," says Bach