Telehealth Hospitalists: Key Ally in Fight for PAMA Compliance

Telehealth Hospitalists: Key Ally in Fight for PAMA Compliance

 Jason Perlman MD, MHS, Clinical Professor | President and Co-Founder of TelehealthSolution

Published on Published onNovember 3, 2017

Less than a year from the implementation of PAMA’s Medicare reimbursement penalties for 30-day rehospitalizations, many Skilled Nursing Facility administrators are left calculating how hard their facilities will be hit and how to plan for the waters ahead.

Starting on October 1, 2018, SNFs will have part of their Medicare reimbursements held in penalties if they have higher than target numbers of medically unnecessary readmissions to the hospital within 30 days of discharge. This makes sense, since 78% of 30-day hospital readmissions are medically unnecessary, and these readmissions lead to a higher rate of additional medical complications for the patients who are supposed to be recovering.

SNFs obviously want to provide patients with the best possible care, including reducing 30-day readmissions, but researchers have found that post-acute care settings face serious limits in improving this outcomes measure.

As hospitals learned from the implementation of similar penalties for 30-Day Readmissions under the Affordable Care Act, communication and coordination of care remains lacking between hospitals, post-acute care and Skilled Nursing Facilities, outpatient providers, families and patients.* Rural and urban SNFs also struggle with varying staff skill levels and turnover, budget limitations, and the heavy responsibility of training staff in evaluating the medical necessity of transferring care back to the hospital. Telehealth hospitalists offer a helpful solution that doesn’t require patients to leave their recovery beds.

For many SNFs, PAMA can thus be seen as a boon rather than a hurdle. Under PAMA, Skilled Nursing Facilities can get incentives for increasing their level of care. Telemedicine with skilled hospitalists provides a pathway to do that, and a potential leg up for SNFs as they prepare to confront PAMA changes. As acute care experts, virtual hospitalists know what conditions can be handled in-house by post-acute care facilities, whereas outpatient providers are less comfortable making this determination. Involving telehospitalists in post-acute care therefore leads to an overall reduction in unnecessary readmissions, and reduces burdens on SNF staff members. With telemedicine hospitalists, an SNF can have access to an on-call acute care provider 24 hours every day.

As the only telemedicine company to employ hospitalists as its on-call physicians, Telehealth Solution is unique in the services it can provide to SNFs. Partnering with our expert providers can help reduce the burden on SNF staff, improve patient care and outcome measures, and simultaneously lower SNF costs.

* J Am Geriatr Soc 64:614–618, 2016