Telehealth isn’t just a medical convenience for patients living in nursing homes. Telehealth also has the potential to save nursing homes and other long-term care facilities, patients and Medicare significant money in avoiding after-hour hospital trips.
When doctors could be reached via telemedicine to decide whether a patient in a skilled nursing facility should be hospitalized, 29% of the patients evaluated avoided a hospital visit, saving $1.55 million over the course of a year, according to new research from TripleCare physicians’ group and the Targeting Revolutionary Elder Care Solutions Institute.
A telemedicine program offered at a 365-bed skilled nursing facility in Brooklyn between 6 p.m. and 7 a.m. on weekdays, as well as weekends, offered nurses called a toll-free number if they needed a physician to evaluate a change in patient condition, such as fever, chest pain or shortness of breath.
If the patient needed a physical exam, the telemedicine unit would be placed bedside, and the physician and nurse collaborated on the exam. Physicians also accessed patient electronic health records, the research says
In a year’s time, 313 patients were cared for by physicians via telemedicine and 259 (83%) were treated at the skilled nursing facility, including 91 who avoided hospitalization. Another 54 were transported to the hospital, the institute says. “As nursing facilities are called upon to care for higher-acuity patients and drive better clinical outcomes at a fraction of the cost of a hospitalization, systems that deliver better quality physicians to the bedside at times of a change of condition will be required,” the study says.
Using telehealth to diagnose and treat patients at their facility rather than a more expensive trip to the hospital could save Medicare—which pays for the care once the patient is in the hospital—and other insurers as much as $1.6 million annually for a nursing home with 120 beds, the study says. “Payers were the major financial benefactor of telehealth care,” the study says. “Treating patients on site eliminated Medicare’s payment to the hospital, the emergency ambulance, and the facility for the skilled days that some of the patients would have received following a 3-day qualifying Medicare acute care stay.”
“Medicare would save $500,000 in an average 120-bed facility, or $4,167 per bed,” says David Chess, president and chief medical officer of service provider Tapestry Telehealth and co-author of the study. “As nursing facilities are called upon to care for higher-acuity patients and drive better clinical outcomes at a fraction of the cost of a hospitalization, systems that deliver better quality physicians to the bedside at times of a change of condition will be required.”
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