How Telemedicine Addresses Present – and Future – Challenges in Senior Care
The Baby Boomer generation, with 77 million members born between 1946 and 1964, are either at retirement age or near it. Every day, another 10,000 people reach age 65.
As this large generation continues to retire, an increased need for skilled nursing, long-term care and assisted living services will follow suit. Health care leaders seek innovative approaches to face this challenge – approaches that can make impacts this week, not in a few years – are sought.
Avera eCARE® Senior Care® is a telemedicine service with a deep background of experience helping teams at skilled nursing facilities, as well as sites that offer long-term care and assisted living across the U.S. It not only has the services and support facilities need, it also offers pinpoint technology and the understanding of best practices that comes with many years helping literally thousands of residents.
To maintain quality care and manage the unique set of geriatric needs that go with this resident population, successful sites are using eCARE and having great results with minimal investment.
One such result is reduced readmission and transfer rates. “Avera eCARE Senior Care found that highly engaged facilities with on-call 24/7 telemedicine support, including access to geriatric-trained specialists, reduced readmission rates by 13% and reduced emergency transfers by over 67%,” said Josh Hofmeyer, Avera eCARE Senior Care Officer. “Emergency transfers are time-consuming, expensive and uncomfortable for residents. Telemedicine allows teams to spend more time doing the important work of caring for residents.”
The results are apparent: eCARE documented the fact that the overall use of urgent care telemedicine audio-visual encounters in senior care settings resulted in 90% of residents being treated in place.
The standard benchmark the Centers for Medicare & Medicaid Services (CMS) use is the 30-day readmission rate with rates at the 80th percentile or lower considered optimal. An estimated 49% of those admissions are considered potentially avoidable by the CMS. “It’s important to consider how much rehospitalizations are costing your facility per year, as excessive readmissions can result in reduced Medicare payments based on the Value Based Purchasing program and can lead to impacts on a location’s 5-star rating under the Nursing Home Compare program,” Hofmeyer said. “With telemedicine intervention for geriatric patients, facilities can improve quality metrics, lower rehospitalizations, stabilize census and meet CMS compliance program standards – thus improving Value Based Purchasing percentage scores and potentially the 5-star rating.”
eCARE Senior Care offers facility staff direct, full-time access to a geriatric-trained team with board-certified geriatricians, pharmacists, behavioral health experts, social workers and peer-to-peer nursing support staff. This support provides 24/7 answers to multiple clinical questions and concerns, including those focused on medication use or chart reviews, fall assessments and physical or behavioral health consults.
Addressing resident health issues in a timely way is important, before they can escalate and result in a transfer.
“We’ve shown that telemedicine support empowers local staff. They can facilitate a connection to eCARE, utilizing this technology to treat residents’ chronic conditions, urgent needs and emergencies in place, with coordinated care guided by a clinician,” Hofmeyer said.
Administrators and their teams in skilled nursing, long-term care and assisted living centers likely review these metrics, along with others such as comparisons between occupancy rate and beds in facility, or annual ER transfers. They have to consider costs as well, including how much annual rehospitalization may cost their facility or system.
With telemedicine intervention for geriatric conditions, many of these measured areas can be adjusted for the better. After all, excessive readmissions to hospitals mean skilled nursing facilities receive reduced Medicare payments based on the Value Based Purchasing programs. That’s why telemedicine is an effective consideration. It can help LTC sites meet CMS compliance program standards, lower rehospitalization rates and reduce on-call payments in many cases.
“Improved quality performance can reduce Medicare payments withheld. Even a half-percent or 1% improvement can really bring value to a facility’s bottom line,” Hofmeyer said.
That 24/7 access to geriatric-trained experts can improve a facility’s partnership with referring hospitals, managed care organizations, accountable care organizations, and other preferred partners.
“Knowing urgent care telemedicine support is available impacts the reputation of your team and the facility because that referring hospital can improve their own readmission metrics,” Hofmeyer added. “Other parts of the team can achieve their goals as well.”
Organizations such as America Association of Retired People (AARP) estimate that people age 65 and older will outnumber children for the first time in American history in just a decade. “This major shift that’s happening within our population – right now – means that we need to look to innovative solutions to the challenges that lie ahead. Telemedicine is care of the future, yet numerous facilities are already proving its benefits today.”