Long term care providers and legal minds have come together in Orlando this week at the annual American Health Lawyers Association (AHLA) Long Term Care and the Law summit. Monday's speakers provided insight on the regulatory landscape and emphasized the increasing importance of compliance in this intensely regulated area of healthcare.
In her keynote address, Ruth Ann Dorrill, Deputy Regional Inspector General, Office of Inspector General (OIG), U.S. Department of Health & Human Services (HHS), discussed OIG’s 2014 Report on Adverse Events in Skilled Nursing Facilities (SNFs). Moving on to the post-acute space after reviewing acute care quality outcomes, HHS has brought the same intense focus, combined with physician medical reviews, to examine outcomes and try to identify best practices, including those that improve outcomes and reduce costs in order to provide the best care-to-value ratio for patients at various points on the care continuum.
Other key issues for long term care providers that Dorrill addressed were the use of electronic health records (EHRs) in SNFs and the involvement of SNFs (or lack thereof) in public health and emergency response planning. Dorrill feels that long term care facilities need to be a part of that dialogue. Finally, she identified underutilization as a key issue particularly with the rise of new payment models that focus on value and care coordination across the continuum.
During Monday’s “Our Current and Future–What Are Long Term Care Provider Association CEOs Focused On? "session, the panel discussed the likely rise in the need – and cost – of care with the growing aging population. Of particular note, the panel was focused on payment models and the change from fee for service to bundled and outcome based payment. Members of the panel felt that we may see a switch in the future from a regulatory focus on over providing rehab and therapy to underproviding it.
The panel also discussed the increased regulatory oversight, not just from CMS but from state regulators as well. There was some discussion on whether there is anything that the industry can do with self-regulation and setting standards to raise the level of care even higher.
In both of these areas, the panel also discussed the need for standardization of data – and therefore quality measures – across different points in the long term care continuum in order to be able to quantify and prove the value of therapy and services provided.
Many of Tuesday's presentations echoed these themes. Presenters discussed changes to payment models in long term care and bundled payments and how these changes present challenges but also opportunities to improve quality of care. Other presentations discussed recent modifications to the Department of Labor rules with regard to home care and personal care attendant services. And of course, several of the day's presenters focused on ongoing regulatory challenges, including governmental audits and increased False Claims Act enforcement.