{"id":4044,"date":"2023-03-27T15:11:54","date_gmt":"2023-03-27T15:11:54","guid":{"rendered":"https:\/\/ltcally.com\/articles\/?p=4044"},"modified":"2023-04-03T20:14:11","modified_gmt":"2023-04-03T20:14:11","slug":"q2-2023-ltc-providers-playbook","status":"publish","type":"post","link":"https:\/\/ltcally.com\/articles\/q2-2023-ltc-providers-playbook\/","title":{"rendered":"The LTC Provider&#8217;s Playbook: Q2 2023 Edition"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Revamping_Authorizations_and_Accelerating_RPM_Adoption\"><\/span><strong>Revamping Authorizations and Accelerating RPM Adoption<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>In this quarter\u2019s LTC Provider\u2019s Playbook, we\u2019re looking beyond the short-term market and seeing what\u2019s setting the tone for advances in long-term care that will ease challenges and improve our industry. At the top of our list are two key areas: authorizations and the adoption of technology.<\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_82_2 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/ltcally.com\/articles\/q2-2023-ltc-providers-playbook\/#Revamping_Authorizations_and_Accelerating_RPM_Adoption\" >Revamping Authorizations and Accelerating RPM Adoption<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/ltcally.com\/articles\/q2-2023-ltc-providers-playbook\/#The_Future_of_Prior_Authorizations\" >The Future of Prior Authorizations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/ltcally.com\/articles\/q2-2023-ltc-providers-playbook\/#Live_Data_Remote_Monitoring_Improving_Care\" >Live Data, Remote Monitoring, Improving Care<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/ltcally.com\/articles\/q2-2023-ltc-providers-playbook\/#Reducing_Hospitalizations_with_Remote_Patient_Monitoring\" >Reducing Hospitalizations with Remote Patient Monitoring<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_Future_of_Prior_Authorizations\"><\/span><strong>The Future of Prior Authorizations<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The Centers for Medicaid and Medicare Services (CMS) released <a href=\"https:\/\/www.cms.gov\/newsroom\/fact-sheets\/advancing-interoperability-and-improving-prior-authorization-processes-proposed-rule-cms-0057-p-fact\">a proposal that would mandate an electronic prior authorization system<\/a> for Medicare Advantage, state Medicaid agencies, and Affordable Care Act (ACA) plans.&nbsp;<\/p>\n\n\n\n<p>This proposal comes after long-standing grievances from providers across the healthcare industry around the delays and denials caused by lengthy authorization processes. Many have rightly pointed out how such denials impact patient care in a number of ways, including patients forgoing care due to unnecessary delays in getting the care they want authorized by their care plans.&nbsp;<\/p>\n\n\n\n<p>Adding to existing complications, payers maintain different standards for authorizing care and no standardized system exists to streamline the workflow. This proposal could potentially fix that, bringing an electronic approval system to a range of payers covering millions of Americans. This would enable providers to deliver the care their patients want sooner and with less friction.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<figure class=\"wp-block-pullquote\"><blockquote><p>AHCA estimates <a href=\"https:\/\/www.mcknights.com\/news\/as-cms-tightens-vise-on-medicare-advantage-providers-argue-for-even-more-help\/\">savings of ~$437M<\/a> with electronic authorization rolled out across the healthcare landscape<\/p><\/blockquote><\/figure>\n\n\n\n<p>There are benefits to a standardized, electronic approval system that extends beyond patient care. The workload related to authorizations for back office and clinical staff can be eased almost overnight once this system comes online. While the new authorizations system won\u2019t go into effect until 2026, it will be a welcome proof of concept that is needed to bring industry-wide change to authorizations and streamline care delivery.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Live_Data_Remote_Monitoring_Improving_Care\"><\/span><strong>Live Data, Remote Monitoring, Improving Care<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>In today\u2019s long-term care industry, modern operators are proving to be technologically sophisticated providers. Increasingly, these operators are advancing their facilities\u2019 offerings by upgrading to advanced health tech more commonly seen in hospital systems with far greater funding.&nbsp;<\/p>\n\n\n\n<p>The increasing adoption of remote patient monitoring (RPM) devices in skilled nursing show a commitment to improving care outcomes and assisting clinical staff. Additionally, CMS have robust billing guidelines in place for providers that make clear the incentives to adopt this technology more widely.<\/p>\n\n\n\n<p>A multitude of studies over several years has shown the efficacy of RPM in preventing hospitalizations while newer solutions give clinical staff access to real-time data from anywhere, allowing them to keep a closer eye on the status of residents.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Reducing_Hospitalizations_with_Remote_Patient_Monitoring\"><\/span><strong>Reducing Hospitalizations with Remote Patient Monitoring<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p><a href=\"https:\/\/www.providermagazine.com\/Issues\/2020\/August\/Pages\/Health-Technology-Supercharges-During-COVID-19.aspx\">RPM used in a Harvard Medical School study<\/a> of over 7,000 patients:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>86% reduction in Code Blue events<\/li><li>45% reduction in ICU stays for patients transferred from surgeries<\/li><li>9% reduction in length of stays<\/li><\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p>Additional studies have shown that RPM has the potential to reduce hospital readmissions for heart failure patients by as much as <a href=\"https:\/\/leadingage.org\/telehealth-and-remote-patient-monitoring-long-term-and-post-acute-care-primer-and\/#5.2\">627,000 incidents per year<\/a>.&nbsp;<\/p>\n\n\n\n<p>We expect ongoing development of RPM devices that help deliver quality care, which can provide more detailed information than wearables, and require less input from their users (such as charging or remembering to wear the device), especially in the skilled nursing setting.&nbsp;<\/p>\n\n\n\n<p>As more advanced solutions come to market, the adoption of effective devices will follow, allowing providers to gain more granular insights into their residents\u2019 health from anywhere and track trends by analyzing larger data sets. What could follow is a modern approach to preventative care in the long-term care setting that can reduce hospitalizations, improve quality, and aid clinical staff.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n\n<p><a href=\"https:\/\/www.linkedin.com\/company\/ltc-ally\/\">Follow Us on LinkedIn<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Remote patient monitoring and a revamped authorization system. What we\u2019re looking forward to. Read the Provider\u2019s Playbook from LTC Ally now.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[21],"tags":[],"class_list":["post-4044","post","type-post","status-publish","format-standard","hentry","category-newsletters"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The LTC Provider&#039;s Playbook: Q2 2023 Edition | Articles | LTC Ally<\/title>\n<meta name=\"description\" content=\"Remote patient monitoring and a revamped authorization system. What we\u2019re looking forward to. 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