Maximizing Medicare Funding
How Automated Patient Engagement Boosts SNF and ALF Profits
Introduction
Skilled Nursing Facilities (SNFs) and Assisted Living Facilities (ALFs) are constantly seeking ways to improve patient care while maximizing their Medicare funding. The recent Fiscal Year 2025 Skilled Nursing Facility Prospective Payment System Final Rule from the Centers for Medicare & Medicaid Services (CMS) brings significant changes that facilities must navigate. Let’s explore how Analog Informatics’® automated patient engagement systems can help SNFs and ALFs thrive in this new environment.
Understanding the FY 2025 Updates
CMS has announced a net increase of 4.2% in Medicare Part A payments to SNFs for FY 2025, translating to approximately $1.4 billion in additional funding. This increase is based on:
- 3.0% SNF market basket percentage increase
- 1.7 percentage point forecast error adjustment
- 0.5 percentage point productivity adjustment subtraction
While this increase is welcome news, facilities must still contend with the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program, which will redistribute an estimated $196.5 million in FY 2025
Leveraging Automated Patient Engagement for VBP Success
The SNF VBP program withholds 2% of SNFs’ Medicare fee-for-service Part A payments, redistributing between 50% and 70% as incentive payments based on performance. Here’s how Analog Informatics® automated patient engagement can help facilities excel in this program:
- Improved Quality Measures: Automated systems can track and enhance key metrics like rehospitalization rates, directly impacting VBP scores.
- Enhanced Patient Satisfaction: Consistent communication leads to higher satisfaction scores, a crucial VBP component.
- Better Care Coordination: Seamless communication between care teams, patients, and families improves overall outcomes.
- Efficient Data Collection: These systems streamline the collection of patient-reported outcomes, vital for VBP reporting and helps mitigate EMTALA violations.
- Proactive Interventions: Early issue identification allows for timely interventions, potentially preventing negative outcomes that could impact VBP scores.
Addressing Social Determinants of Health (SDOH)
The final rule introduces new SDOH items in the SNF Quality Reporting Program (QRP). Automated engagement systems can assist by:
- Facilitating the collection of SDOH data
- Identifying residents’ needs related to living situation, food, utilities, and transportation
- Supporting discharge planning processes
Preparing for Data Validation
CMS is implementing a validation process for the SNF QRP, requiring approximately 1,500 randomly selected SNFs to share medical records. Automated systems can help by:
- Ensuring comprehensive and accurate documentation
- Streamlining the process of sharing required records
- Maintaining consistent data quality across all patient interactions
We Solved the Problem with Analog Concierge™
Analog Informatics® has developed Analog Concierge™, an AI-powered patient engagement platform designed to address the unique challenges faced by Skilled Nursing Facilities (SNFs) and Assisted Living Facilities (ALFs). Here’s how our solution can transform your facility’s operations and improve Medicare reimbursements
Enhancing Resident and Family Engagement
Analog Concierge™ offers:
- Multilingual communication to connect with diverse residents and their families
- Automated updates on resident status, activities, and care plans
- Personalized engagement throughout the resident’s stay
- AI-driven insights for tailored care plans and interventions
Improving Quality Metrics and Operational Efficiency
Our platform helps SNFs and ALFs:
- Reduce hospital readmissions through proactive monitoring and interventions
- Improve documentation accuracy for better Quality Reporting Program (QRP) performance
- Streamline data collection for resident-reported outcomes and experiences
- Optimize performance on key Value-Based Purchasing (VBP) metrics
- Manage Social Determinants of Health (SDOH) data effectively
Maximizing Medicare Reimbursements
Analog Concierge™ contributes to improved financial outcomes by:
- Increasing resident satisfaction scores, leading to higher Medicare reimbursement rates
- Enhancing performance in the SNF Value-Based Purchasing (VBP) program
- Improving accuracy in Patient-Driven Payment Model (PDPM) coding
- Streamlining data validation processes for the SNF Quality Reporting Program
- Managing online reputation to indirectly impact resident acquisition
Seamless Integration with PointClickCare
As a PointClickCare vendor, Analog Concierge™ offers:
- Effortless integration with your existing EHR system
- Automated updates to families directly through PointClickCare
- Personalized, multilingual communication with residents and families
- Data-driven insights to optimize care plans and recovery outcomes
Addressing Staffing Challenges
Our AI-powered solution helps alleviate staffing pressures by:
- Automating routine communication tasks, reducing administrative burden
- Providing an AI patient concierge to address common inquiries
- Streamlining processes like appointment management and review solicitation
- Fostering positive resident experiences, potentially improving staff job satisfaction
The Bottom Line
With utilizing automated patient engagement systems like Analog Concierge™, SNFs and ALFs can not only adapt to these regulatory changes but also maximize their Medicare funding. These systems help facilities improve their VBP performance, optimize PDPM reimbursement, address SDOH effectively, and ensure data accuracy for validation processes. In an industry where every dollar counts, investing in automated patient engagement is more than just a technological upgrade—it’s a strategic move to boost profitability while enhancing patient care. As the healthcare landscape continues to evolve, facilities that embrace these innovative solutions will be best positioned to thrive financially and provide superior care to their residents.
By leveraging Analog Concierge™, SNFs and ALFs can significantly improve resident engagement, leading to better outcomes, higher satisfaction rates, and increased Medicare reimbursements. Our solution not only enhances the resident experience but also contributes substantially to the financial health and operational efficiency of your facility.
Analog Informatics Corporation (AIC) is the leader in AI healthcare customer relationship management (CRM), marketing, and engagement. Let’s work together to deliver happier and healthier patients, and make your business more successful.
