Host of Payment Matters
On this episode of Payment Matters, Jeff is joined by Luis Montes, SVP of Strategic Partnerships at Casamba, a leader in EMR software for post-acute care. Jeff and Luis discuss the unique challenges facing post-acute care organizations, particularly when it comes to payment reform and consumerism. Here is a summary of their conversation:
What are some unique challenges for post-acute care organizations?
The importance of post-acute care in healthcare is growing dramatically and it’s becoming a more prominent setting over the past 10 years or so. The primary reason for this is that patients are spending less time in the hospital setting. If you had a hip replacement twenty years ago, you might stay in the hospital for a week and then maybe go into an inpatient rehab facility and stay there for a month. The velocity of care now in hospital systems is much faster. Patients are discharging right away to a more cost-effective care setting. Additionally, hospitals are participating in value-based care models like bundled payments and are more often referring patients to post-acute care facilities.
What does the post-acute care patient population look like?
We see a lot of seniors in post-acute care, and as a result the primary payer for many post-acute care organizations is Medicare, but we have seen a shift here as well. A good friend of mine in his forties recently suffered a bad knee injury, and he ended up in a skilled nursing facility. You don’t expect a healthy forty-year-old to end up in a facility like that – what we used to call years ago a nursing home – but he did because he needed rehab and that was the best place for him to do it. We’re also starting to see more young patients with things like traumatic brain injuries, as well as more acute patients because the hospitals are discharging sooner.
What is your take on consumerism and the consumer experience in post-acute care?
Mergers and acquisitions in the post-acute care space is hurting the consumer experience, because consolidation leads to less competition, which usually leads to less quality. Overall, healthcare providers are thinking now more than ever about the experience of the customer. We’re starting to see that the healthcare consumer in post-acute care is taking more time to research their providers and choosing where they receive care. This is especially true for patients with high deductible plans.
We’re also starting to see more patient-generated feedback, on social media and through apps like Yelp or Google, and post-acute care organizations are responding. It’s not uncommon now to walk into a skilled nursing facility and feel like you entered a nice hotel. There has also been more investment in technology and medical devices, the quality of the food, premises and aesthetics – and these are all good improvements.
How have payments changed for post-acute care organizations?
Payment reform has been geared towards risk sharing and a patient driven model, and it’s been shifting away from the fee-for-service model. Since Medicare is the largest payer in post-acute care, we’re starting to see a lot of providers adopting some of the initiatives that Medicare has put fourth over the past ten years.
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About the Host
Jeff Lin is Senior Vice President of Product Management at InstaMed. As head of Product Management, Jeff leads the ongoing product innovation of InstaMed’s healthcare payment solutions. This includes the exploration, evolution and execution of InstaMed products that further simplify the healthcare payments process. Before joining InstaMed, Jeff was an executive at Accenture, where he led multiple enterprise projects for multiple Fortune 100 companies. Jeff’s experience and expertise include a deep focus in the areas of product management, product strategy, product marketing and developing strategic partnerships. Jeff graduated from UCLA with a Bachelor of Science in Microbiology and Molecular Genetics. In his free time, Jeff enjoys spending time with his wife and sons and traveling and dining around the world. Jeff earned the Eagle Scout ranking as a Boy Scout and is an avid fan of any activities in the California sunshine.