Post-acute care (PAC) providers rely on referrals from acute care settings to grow their businesses and drive revenue. Current trends such as taking on risk, participating in value-based care, and the modernization of discharge planning, mean PAC providers will need to prepare for a new landscape of care.
As the PAC landscape continues to shift, demand for post-acute care (PAC) continues to increase despite rising referral rejection rates. According to data from CarePort, powered by WellSky, the rate of referral rejection among skilled nursing facilities (SNFs) had climbed to 88% by the first quarter of 2022. Home health rejection rates also grew to 71% from 49% despite doubling the number of referrals since 2020.
Longer hospital lengths of stay also signify sicker patients, and when post-acute discharge opportunities are scarce, hospitals are forced to keep some patients longer. This results in higher acuity patients, and potentially reduced access to appropriate care, and rising readmission rates. Additionally, due to a growing geriatric population and rising costs, post-acute care is shifting away from institutional care and toward less-expensive home-based care.
Post-acute care providers need to make changes to meet these new challenges and position their organizations to benefit from the shifts taking place. Effective referral management solutions can help post-acute providers streamline their referral and discharge planning process and meet the rising demand for quality post-acute care.
Here are ways your post-acute organization can optimize referral management:
Fast referral responses are essential to increasing admissions. Hospitals are experiencing spiking hospital acute length of stay (ALOS) and need to find beds for their patients. Quickly responding to referrals not only increases the probability of placement but improves the metrics hospitals look at when deciding where to refer their patients. Inefficient and manual internal systems and processes, such as the use of fax, phone, and data entry, can prevent PAC providers from responding to referrals quickly. A central referral management solution is a critical tool to help PAC admission staff consolidate, review, and respond electronically to referrals from acute care settings, all in one place. When PAC providers have the ability to receive and respond to referrals efficiently, it allows for increased collaboration, eliminates the need for manual work, and drives efficiency.
Maintain accurate provider profiles
Providing accurate, up-to-date data to referral sources is critical for effective referral management. Minor differences or spelling mistakes in provider names, accepted insurance, or clinic locations can lead to duplication or inaccurate provider information. It is also essential to provide up-to-date access to information like bed availability and services to improve patient matching. While it can be challenging for PAC liaisons to market their facility to hospitals, having an up-to-date profile provides an opportunity to increase visibility to referral sources and give discharge planners accurate information at their fingertips.
Analyze referral metrics
By analyzing referral metrics, providers can gain visibility into referral patterns such as where referrals are coming from and how quickly referrals are converted into patient admissions. In addition, real-time referral metrics can provide insight into performance and help identify gaps in care, opportunities for improvement, and the needs of the market. Furthermore, when PAC providers bring data to referral sources, it helps strengthen partnerships and increase participation in preferred networks. Without a system to analyze referral data in place, it can be challenging to make informed, data-driven decisions.
How CarePort®, powered by WellSky® can help
For post-acute providers, optimizing referrals is critical to care coordination. With CarePort, organizations can streamline the referral workflow, improve patient outcomes, alleviate staff burden, drive revenue, and perform better on the metrics referral sources care about.
CarePort Referral Management allows providers to receive, respond, and review all patient referral activity in a single easy-to use system. With Referral Management, providers can:
- Share bed availability, automatically receive and respond to referrals, and enter referrals from non-electronic sources
- Save time and errors by automatically transferring patient demographic, financial, and clinical data to back office clinical and financial systems
- Access real-time reporting tools to gain insights on referral sources and patterns
Learn more about how CarePort®, powered by WellSky® can help your organization take the challenge out of referrals.