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Healthcare costs are rising, but reimbursement isn’t keeping up. Rehab therapy cost management and optimal patient outcomes need to coexist.

Skilled Nursing Facilities (SNFs) play a vital role in the continuum of senior care in Wisconsin. Namely, they provide much-needed access to physical, occupational, and speech therapy services. These rehabilitation services are crucial for helping residents regain functional abilities, improve their quality of life, and ultimately achieve successful discharge. However, ensuring effective rehab therapy needs to go hand-in-hand with managing the cost of administering it.

Today, SNF owners face increasing pressure to deliver high-quality care while also maintaining financial sustainability. Thankfully, there are strategies specifically designed to help SNF owners and administrators achieve this delicate balance.

Let’s explore the challenges inherent in determining and managing rehab therapy costs and look at practical solutions to optimize therapy department’s operations. By implementing these strategies, SNFs can focus on delivering exceptional patient outcomes through effective rehab therapy—all while maximizing a cost-effectiveness that contributes to the financial health of the facility.

The Challenges of Rehab Therapy Cost Management in SNFs

The true cost of delivering speech, occupational, and physical therapy in the SNF setting is a complex, multifaceted equation. It factors in variables such as the cost of hiring therapy professionals, reimbursement costs for Medicaid services, out of pocket costs for patients, facility costs, and more. At the same time, SNFs need to consider the unique needs of residents, whose individualized care plans have differentiated costs associated with them.

In short, balancing quality care with cost efficiency in a SNF’s rehab department presents a unique set of hurdles. Here’s a closer look at some of the major factors contributing to rising rehab therapy costs:

  • Staffing Shortages and High Therapist Salaries. The demand for qualified therapists often outpaces the supply, driving up salaries and making it difficult to maintain adequate staffing levels. This can lead to increased reliance on therapist overtime, further straining budgets. Salaries for therapists in some regions significantly exceed the national average, adding financial pressures for SNFs. Contracting speech, occupational, and physical therapists can help alleviate these challenges, since the cost therapist time is ultimately borne by the contract therapy company.
  • Reimbursement Limitations. Reimbursement models from Medicaid and other payors often limit the amount SNFs receive for rehab services, regardless of the actual cost of providing care. This disparity can create situations where direct access to high-quality, intensive therapy becomes financially unsustainable. Insurance companies work with in-network providers to establish reduced fee schedules, affecting reimbursement and highlighting the need for SNFs to navigate these financial intricacies. It’s a problem further exacerbated by variations in insurance plans among patients—particularly where Medicare Advantage Plans are concerned.
  • Length-of-Stay Pressures. Therapy comes at a cost to payors and there’s often an incentive to discharge patients quickly to keep costs low. This can pressure therapists to condense therapy schedules, which can hamper outcomes. This might lead to readmissions or a need to pay for additional therapy services at a later date, ultimately increasing overall costs. Likewise, high deductible insurance plans or Medicare Advantage Plans may not offer insurance coverage adequate to reimburse a proposed length of stay.
  • Inefficient Scheduling and Documentation Practices. Time spent on inefficient scheduling, cumbersome documentation processes, or duplicated efforts across rehab disciplines can significantly reduce therapist productivity. Unbillable time equates to revenue lost for the facility. It also translates to reduced patient contact and higher therapist costs.

These challenges highlight the need for a multi-pronged approach to cost management in SNF rehab departments. Regardless of a resident’s specific plan or disability, SNFs need to consider utilization costs and patient outcomes in tandem.

Strategies for Cost Management

Balancing a SNF rehab therapy department for both cost management and optimal outcomes requires a strategic approach: one that tackles both staffing and operational inefficiencies. Here are some key strategies to consider:

1. Scheduling for Speech, Occupational, and Physical Therapists

Maximize Therapist Skillsets. To maximize therapist utilization, employ effective caseload management strategies that ensure therapists are assigned patients based on their specific skillsets and needs. This may include group or concurrent strategies where occupational and physical therapy overlap. Or, it might include situations where an occupational therapist with expertise in stroke care works with these patients vs. someone with a more generalized OT skillset.

Utilize Assistants or Aides. Explore delegating appropriate tasks to qualified assistants like physical therapist technicians or occupational therapy aides. By delegating repetitive or routine tasks, therapists are freed up to focus on higher-level interventions that require their specialized skills. That said, be aware of the cost of employing assistants and make sure their part- or full-time salary costs are offset elsewhere.

Utilize Software. Most rehab departments are using some type of electronic medical records (EMR) or electronic health records (EHR) system that includes a patient scheduling function. The key is habitually using it to maximize therapy scheduling, to ensure therapist availability, reduce scheduling conflicts, and ensure smooth patient transitions.

Embrace Telehealth. Telehealth offers a range of benefits for cost management in SNF rehab therapy. It can be a valuable tool for conducting initial assessments, providing follow-up care, or collaborating with caregivers remotely. This can potentially reduce the need for in-person visits, saving time and associated travel costs for both therapists and patients.

2. Standardization and Collaboration

Develop Standardized Treatment Protocols. Implement evidence-based treatment protocols tailored to a resident’s specific functional status and goals. This not only promotes efficient use of therapist time and targets desired outcomes; it also ensures therapy time is optimized to achieve desired results by utilizing data on patient progress and outcomes to refine treatment plans. Collaboration with a care team is essential!

Foster Collaboration Between Care Teams. Strengthening collaboration between rehab therapists, physicians, nursing staff, and patients/families is crucial for cost management. By working as a cohesive unit, different care team members can ensure all interventions are coordinated to avoid duplicative medical services. This approach can also help manage patient and family expectations by establishing clear communication channels around treatment goals, progress updates, and anticipated discharge timelines. Effective communication can enhance documentation, improve outcomes, facilitate smoother discharge, and ensure efficient use of resources.

3. Coding and Documentation

Prioritize Accurate Coding and Documentation. Accurate coding and documentation are essential for maximizing reimbursement and minimizing denials of payments by insurance companies. Invest in staff training to ensure therapists are proficient in current CPT coding practices and consistency in documentation for MDS scoring. Additionally, streamline documentation processes by utilizing efficient EHR systems with pre-populated templates and standardized terminology. This can significantly reduce the time therapists spend on paperwork, allowing them to dedicate more time to patient care.

Balancing Cost Management with Quality Care

In healthcare, discussions about cost management and care outcomes can feel diametrically opposed. Therapists often see cost discussions as counterproductive to care discussions, but they don’t need to be. While cost management is a crucial aspect of SNF rehab therapy, it should never come at the expense of patient well-being—and good therapists know it. Here’s how to strike the right balance:

  • Invest in Ongoing Therapist Training and Education. Keeping therapists up-to-date on the latest treatment techniques and best practices ensures they’re delivering the most effective care possible. This can lead to improved patient outcomes and potentially reduce the overall length of stay and need for additional therapy services. Connect the dots between exceptional care, optimal outcomes, and cost-effective results.
  • Implement Performance Monitoring and Quality Improvement Initiatives. Regularly monitor performance metrics like patient progress, readmission rates, and length of stay. Use this data to identify areas for improvement and implement targeted interventions to enhance quality of care. This data-driven approach allows Rehab Directors (RDs), Directors of Nursing (DONs), and facility administrators to continuously refine practices and ensure the SNF delivers the best possible outcomes for residents.
  • Prioritize Patient and Family Satisfaction Surveys. Regularly gather feedback from patients and families regarding their experience with rehab therapy services. Patient satisfaction is a key indicator of quality care. By actively listening to their feedback, it’s easier to identify opportunities to improve patient engagement and experience while ensuring care aligns with expectations.

Navigating insurance requirements is also essential for quality patient care. Many insurance plans require a referral from a primary care provider to cover the costs of physical therapy, highlighting the importance of understanding these prerequisites for accessing covered rehab therapy services.

Effective cost management in rehab therapy is NEVER about cutting corners; it’s about optimizing operations, maximizing therapist efficiency, and delivering high-quality, evidence-based care. Remember, it’s possible to achieve financial sustainability and exceptional health outcomes for residents who rely on rehab services.

Cost Effective Speech, Occupational, and Physical Therapy Services

The landscape of SNF rehab therapy is constantly evolving. By implementing cost-management strategies—from optimizing staffing and scheduling to fostering collaboration and prioritizing accurate coding—we can ensure a SNF delivers efficient, high-quality care that maximizes positive patient outcomes.

Remember, cost-effective rehab therapy doesn’t need to be a zero-sum game. By prioritizing efficiency, service, and strategic resource allocation, therapy can empower a SNF to achieve a win-win situation: maximizing financial health while ensuring residents receive the high-quality rehab treatments and services they deserve.

Key Takeaways

  • Effective cost management requires a combination of strategies that address staffing, scheduling, collaboration, documentation, and quality improvement initiatives.
  • Delegate tasks, utilize technology for scheduling and documentation, and implement standardized protocols to free up therapists for high-value patient interaction.
  • Invest in therapist training, monitor performance, and prioritize patient satisfaction. Effective cost management ultimately supports delivering the best possible care.

Need help balancing the scales between cost-effective care and exceptional patient outcomes in your rehab therapy department? Reach out to us today to explore these strategies and more!