Overview of SNF-at-Home
Approximately 25% of short-stay SNF episodes can be cared for in the home setting vs. a SNF facility, representing an opportunity for in-home providers, according to statistics from Lincoln Healthcare Leadership. SNF-at-Home represents a $20 billion opportunity for Home Health.
Two emerging models reflect the level of support needed:
- SNF-at -Home “Light” encompasses Home Health and Personal Care
- SNF-at-Home “Full Blown” includes Home Health, Personal Care, RPM, Phys. Services, DME, etc.
SNF diversion is already underway. Since the pandemic started, public policy experts and seniors have expressed an increased preference for the home. More seniors and their families are looking for higher acuity care in the home setting. Families are seeking help in how to modify their homes (or their loved one’s homes) with necessary equipment. Patients and family caregivers experience a smoother discharge process, more coordinated care, and easier billing. Most importantly, the SNF-at-home model leads to lower hospital readmissions and higher patient (and family) satisfaction.
Payment Challenges
“Traditional home health care payment will not be sufficient given these individuals will require a mix of both skilled home health care services and also home care assistance with activities of daily living,” David Grabowski, a professor in the department of health care policy at Harvard Medical School, told Home Health Care News in an email. “The model will have to recognize these enhanced service needs.”
Grabowski envisions that the unified site-neutral payment model that the Medicare Payment Advisory Commission (MedPAC) has been working on could support the SNF-at-home model. “Rather than focusing on payment by setting, the unified payment model focuses on payment by condition,” he shared. “For example, an individual recovering from a hospitalization for a stroke would be associated with the same reimbursement regardless of where they were discharged. Site-neutral payment would allow the care of patients in the home who previously would have been discharged to a SNF.”
Role of Telehealth
Virtual care is critical to making the SNF-at-home model happen as technology enables patients to have more meaningful interactions with clinicians. A high-touch and high-tech approach leverages clinicians practicing at the very top of their license (certified nursing assistants, nurses, home health aides) with innovative clinician and patient use of technology.
Synzi’s telehealth and virtual care platform helps home health agencies and post-acute care organizations deploy the SNF-at-home model with HIPAA-compliant video, secure messaging, text, and email for clinician-to-clinician and clinician-to-patient communications. Supporting the high-touch angle, agencies also use Synzi to drive patient engagement by scheduling and pushing out a cascade of condition-specific messages, helping to drive adherence and lower rehospitalizations. Synzi’s RPM tool enables patients to easily share their vital signs with clinicians and referral partners (such as the patient’s primary care physician). Administrators can also create, send, and conduct patient assessments on a regular basis. With Synzi’s dashboard reporting, agencies have real-time insight into the patient’s condition and can quickly explore if the plan of care needs to be changed prior to the next visit and/or facilitate real-time interventions.