Should Long Term Care Facilities be part of ACOs?

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Some wonder if long-term care facilities (LTC) should be part of ACOs. CMS recently issued proposed guidelines for ACOs, and LTC facilities. According to an article in McKnight’s, LTC facilities are integral to ACOs. The article, “Nursing homes must be a part of ACOs,” states nursing homes are “perfect partners” for accountable care organizations and don’t want to be left behind in the changing healthcare landscape. AHCA/NCAL President and CEO Mark Parkinson states:

We want to be a part of ACOs. The system, as it exists now, does not have enough incentives to keep people from long hospital stays or return visits to healthcare facilities. One of the understated benefits of ACOs is the potential savings in the changing of the reimbursement systems. We want to take the incentives out of treating people longer.

I read another article last week, “A successful ACO must have a strong long-term care component,” which also discussed the importance of the relationship between LTC facilities and hospitals. The author, Anthony Cirillo, states:

I perform work on “both sides of the house,” that is I consult with hospitals and also with aging services providers. And it occurs to me these separate entities need to start talking to each other. Because as hospitals theoretically switch from a sickness to a wellness model and coordinate care throughout the continuum, aging services providers will be in some way part of the hospital’s accountable care organization.

As LTC facilities move towards an ACO model, how will this change affect LTC pharmacists? Over the last few years, the acuity level in LTC facilities has continued to rise and facilities need help to service this increased growth in short stay population. LTC nurses already have full schedules with multiple tasks, including managing and administering medications since most LTC facilities do not have the luxury of having a full time pharmacist on the patient care team.

Here at Talyst, we’ve found that one solution is remote dispensing technology. Remote dispensing puts a medication dispensing unit directly at the LTC facility so that after Pharmacist approval, medications can be dispensed 24/7 to facilitate late admits, STAT orders, first doses, and PRNs. The technology frees nurses so that they have more time to spend with their residents and are able to provide the highest-quality care. It also allows pharmacists to be more directly involved in patient medication therapy management by tracking several times a day any medications delivered to the patients from the “emergency kit”.  Many of our customers report saving 50-70% of time spent on administering medications with our remote dispensing technology.  The remote dispensing unit also logs all medications dispensed for a patient and can be useful for updating an Electronic Health Record if the nursing home facility needs to provide that information to a hospital after discharge or on readmission.

Do you work at an LTC facility? Are you aware of ACOs? Do you think LTC facilities are integral to ACOs? Would like to hear your thoughts and start a discussion.

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