How Skilled Nursing Facilities Are Increasing Costs to the Healthcare System
As many may know, healthcare in the United States is one of the most expensive compared to countries abroad like Europe or Korea. We hear about patients falling into the donut hole all the time and about all the uninsured people who have no access to healthcare. So what is contributing to the skyrocketing prices of United States healthcare? One contributing cause is skilled nursing facilities which many people don’t think about. When people with no insurance or a stable access to healthcare get really sick, their only choice is to get treated at the emergency department. But that’s not the final stop for patients who need further treatment and rehabilitation.The emergency rooms only have so many spaces for patients so once an immediate problem is fixed, the patients have to go somewhere, and that’s usually a skilled nursing facility if they require further temporary medical care. Besides the immediate costs of the emergency room visit, patients end up having to pay for their temporary stays at skilled nursing facilities which can last from a few weeks to a few months.
Seeing as how a typical emergency room visit is around $3000, and an average payment for a skilled nursing facility stay is about $10,200, patients who can’t afford healthcare aren’t able to pay these exorbitant amounts. So what happens to all the debt occurred? The hospitals and facilities cover what they can and the rest comes from the government-- which means our taxes. The expensive healthcare in the US would be justifiable if our quality of care matched it, but does it? Patients who end up getting discharged to skilled nursing facilities (SNF) have a 21% 30-day readmission rate with an average payment of $10.2K compared to to inpatient rehab facilities which only had a 7.2% 30-day readmission rate and an average payment of $17K. To give a better perspective, from 2000 to 2006 the 30-day readmissions rates for SNFs increased by 29% and in 2006, the cost to Medicare was a whopping $4.34 billion, but get this-- in a study done with Dr. Vincent Mor from Brown University, approximately $3.39 billion of that cost was potentially avoidable.
So costs having been increasing in SNFs, but the quality of care seems to have gone down. Why is that? It’s hard to say, but with hospitals discharging patients faster to see more patients (and make more money), the patients getting discharged to SNFs are afflicted with worse conditions than in the years past and yet SNFs haven’t been upgraded to have the necessary medical personnel or equipment to fully treat some of these patients (e.g. patients with CHF, respiratory infection, UTI, sepsis, electrolyte imbalance, etc). There’s a lot of improvement to be made with the US healthcare and its costs, but perhaps the first step could be to increase the quality of care and not just the expenses. With the changing vision of quality over quantity, I hope to see SNFs being utilized to their full potential in providing better care and cheaper costs.
Seeing as how a typical emergency room visit is around $3000, and an average payment for a skilled nursing facility stay is about $10,200, patients who can’t afford healthcare aren’t able to pay these exorbitant amounts. So what happens to all the debt occurred? The hospitals and facilities cover what they can and the rest comes from the government-- which means our taxes. The expensive healthcare in the US would be justifiable if our quality of care matched it, but does it? Patients who end up getting discharged to skilled nursing facilities (SNF) have a 21% 30-day readmission rate with an average payment of $10.2K compared to to inpatient rehab facilities which only had a 7.2% 30-day readmission rate and an average payment of $17K. To give a better perspective, from 2000 to 2006 the 30-day readmissions rates for SNFs increased by 29% and in 2006, the cost to Medicare was a whopping $4.34 billion, but get this-- in a study done with Dr. Vincent Mor from Brown University, approximately $3.39 billion of that cost was potentially avoidable.
So costs having been increasing in SNFs, but the quality of care seems to have gone down. Why is that? It’s hard to say, but with hospitals discharging patients faster to see more patients (and make more money), the patients getting discharged to SNFs are afflicted with worse conditions than in the years past and yet SNFs haven’t been upgraded to have the necessary medical personnel or equipment to fully treat some of these patients (e.g. patients with CHF, respiratory infection, UTI, sepsis, electrolyte imbalance, etc). There’s a lot of improvement to be made with the US healthcare and its costs, but perhaps the first step could be to increase the quality of care and not just the expenses. With the changing vision of quality over quantity, I hope to see SNFs being utilized to their full potential in providing better care and cheaper costs.
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