Post-acute providers often lack budget to implement critical health IT

Almost one in five post-acute facilities have been operating at negative margins for the past five years or longer, a BlackBook survey of 1,640 providers of long-term and post-acute care revealed, and 84 percent of post-acute administrators report having no budgeted funds for technology acquisitions or improvements in 2019.

Post-acute care providers are at continued risk in 2020 due to underfunding from their respective states, rising labor costs and complicated documentation requirements, with "very limited funds" for any new IT and tech-related staffing.

While health information exchanges – both public and private – health analytics, workflow and care coordination, and patient engagement systems could improve post-acute patient care, slow adoption rates and fragmented health IT environments are hampering progress.

Meanwhile, just under half (49 percent) of all post-acute providers surveyed said the state of their staff's health information technology proficiency is either "extremely poor" or "non-existent," and just four percent of inpatient long-term care providers said they had data-driven analytics capabilities.

"As patients move from acute-care facilities to post-acute care, the sharing of critical patient information is vital for coordinating care, particularly under value-based care models," Doug Brown, founder of Black Book Research, told Healthcare IT News.

"As more value-based reimbursement reforms affect both the acute-care and long-term and post-acute care markets, patient data-sharing is essential for reducing readmission rates and advancing outcomes," he said.

Brown pointed out the lack of data and analysis is excluding most long-term and post-acute providers from value-based care programming.

Meanwhile, the design of some of those initiatives, such as bundled payments and shared risk, could feasibly lead to the provision of fewer post-acute services.

"Simplifying connectivity between hospital and post-acute care systems generates enormous opportunities for cost reduction, reduced patient transfer workloads, and overall improvements in care," Brown said.

However, with an inability to coordinate data from acute care providers to their existing electronic health records, post-acute providers will be increasingly unable to deliver the type of care mandated by CMS, which Brown said would "certainly negatively impact" the opportunity reimbursement and patient health outcomes.

"Unfortunately, to cut costs, some value-based care participants may seek to bypass post-acute care or limit stays in ways that may be contradictory with care plan goals and timelines required in the regulations and even encourage inappropriate early discharges," he said.

Despite the challenges, Brown said it was "encouraging" to see that some leading health systems with developing VBC programs are showing signs of post-acute care inclusion by focusing on the role of skilled nursing, rehabilitation, home health and sub-acute providers.