What BPCI Models 2 & 3 Mean for Skilled Nursing Facilities

Comprised of four broadly defined models of care, the Bundled Payments for Care Improvement (BPCI) initiative establishes a total budget for all services provided to a beneficiary throughout a given episode of care. These models have the potential to reduce Medicare or Medicaid expenditures, while leading to higher quality and more coordinated care. While Model 1 was focused on the inpatient stay at an acute care hospital, Models 2 and 3 cross care settings to include post-acute providers.

In Model 2, the inpatient stay in an acute care hospital, plus the post-acute care and all related services up to 90 days after hospital discharge, are included. In Model 3, the episode of care is triggered by an acute care hospital stay, but officially begins at the initiation of post-acute care services with a skilled nursing facility.

So, what does this mean for post-acute care providers? Because Medicare establishes a total budget for all services provided to a beneficiary throughout a given episode of care, regardless of setting, it’s essential for care providers to deliver high-quality services that drive positive outcomes. If a hospital discharges their patient to a skilled nursing facility (SNF), only to have that patient return to the hospital because they weren’t receiving appropriate care, the cost of treating that patient’s episode of care increases.

As a result, hospitals are looking to partner with SNFs who can demonstrate their various quality measures, outcomes, and length of stay — helping to reduce the possibility of rehospitalization. For SNFs to prove their ability to meet or exceed the care expectations of acute care providers, it’s essential to have the right systems and processes in place to capture, manage, and share the necessary patient data.

Providers who are ahead of the curve will be viewed more favorably by other healthcare organizations, and are more likely to receive referrals from acute care partners. Using a tool to monitor the facility’s readmission data, CKPIs, and quality measures will help providers quickly identify and address any areas of concern before things escalate. Solutions that integrate with the facility’s electronic health record (EHR) provide real-time insights that can then be easily shared with acute care providers (versus transcribing all the information into a paper form or spreadsheet).

However, having insight into the health status of residents is just as important as monitoring quality measures, since resident status has a direct influence on them. Plus, if a resident is readmitted back to the hospital for preventable issues, the referral relationship with the hospital could be jeopardized.

To better track residents at risk of readmission and assist with care coordination across the continuum, SNF providers are leveraging eINTERACT. This electronic version of INTERACT integrates directly with the EHR to help automate the process, making it easier to identify changes in health and communicate those changes to the appropriate staff members.

Watch our webinar to learn more about eINTERACT and how facilities are using it to reduce the potential for hospital readmission: