Is the Time Right for Skilled Nursing Facilities to Embrace Telehealth?

Two large skilled nursing facilities will soon be testing the post-COVID-19 theory that telehealth is here to stay.

Southview Acres Health Care Center in St. Paul, MN, and Affinity Healthcare Center in Paramount, CA, will be piloting a connected health platform this fall from Curve Health. The platform provides SNF staff with telemedicine tools that connect them with physicians and specialists, allowing them to seek help whenever a resident is in need of healthcare services.

SNFs and other assisted living facilities have traditionally faced difficulties using telehealth for resident care, primarily due to low reimbursement and challenges in proving sustainability. Few facilities were able to justify the expense of a telehealth service that Medicare wouldn’t support, and they couldn’t find enough data to prove better clinical outcomes over a large population.

That changed with COVID-19, which prompted state and federal lawmakers to ease the rules on telehealth access and coverage. Faced with a lack of access to in-person care, SNFs joined the rush, looking for platforms that would allow them to provide virtual care for residents without bringing in providers or transferring them to local hospitals.

"The pandemic has opened the industry's eyes to the importance of telemedicine-based services in SNFs, and the regulatory environment now supports the growth of Curve and its partnership with forward-looking organizations like Southview,” Avi Katz, who owns Southview Acres, said in a May 6 press release announcing the partnership. “We're expecting the immediate accessibility of physicians to enable a more seamless patient and family experience and a significant decline in unnecessary hospitalizations."

The partnership also marks Curve Health founder Tim Peck’s second shot at telehealth sustainability.

Peck launched his previous company, Call9, in 2014, pushing telehealth into nursing homes as a means of reducing unnecessary and costly emergency transports and hospitalizations. But the success stories were few and far between, Medicare rules for telehealth were far too restrictive and the reimbursements weren’t enough to support the programs. Peck folded Call9 in 2019, vowing to try again.

“We talk about the shift to (value-based care) all the time … but we haven’t made the switch,” he told mHealthIntelligence in mid-2019. “We need to flip that switch from fee-for-service … and start rewarding (providers) for bringing value to patient care.”

Peck now thinks that switch is happening. He launched Curve Health in April 2020, fortified by $6 million in seed funding and an ongoing pandemic that was fueling an embrace of virtual care.

In November, a study conducted by researchers at the University of California in Irvine and published in the Western Journal of Emergency Medicine helped prove his point. The study found that a telehealth platform used by six SNFs reduced unnecessary transfers by as much as 80 percent.

“We have a lot of momentum now,” he said recently. “Doctors are using telehealth much more now (then before the pandemic), and payers want this as well. The world has changed even if our mission never changed.”

Peck says the coronavirus forced the nation’s healthcare industry to embrace telehealth much faster than it would have without the pandemic. For SNFs and assisted living facilities, that transition was much needed. They’ve always been on the front lines of the pandemic, dealing with people much more susceptible to catching the virus and incurring its worst effects, including death. A telehealth program could literally be a life-saver for them.

Curve Health is one of many telehealth vendors to jump into the space, and Peck says it’s important for SNFs to study the platform before choosing a partner. Some will partner with local physician groups or agree to partner with those recommended by the SNF, while others offer their own physician network. It’s also important to examine the technology used, to make sure SNF staff have an immediate link to an on-call physician and with nearby hospitals when triage and transfer are needed.

In addition, as has been proved during the pandemic, while the key to telehealth success lies in improved clinical outcomes and reduced costs, the platform also has to help nurses and staff, many of whom bear of the brunt of workflow changes. Concepts like ease of use, engagement and compassion are just as important for the providers as they are for the patients.

As the nation moves away from the pandemic, SNFs and other assisted living facilities will want to keep their telehealth programs in place – but they’ll still need help. When the public health emergency ends, so do the emergency measures that allowed greater telehealth expansion and coverage. Some states have moved to make those freedoms permanent, while other are waiting on the federal government and Congress to set long-term telehealth policy.

Peck is aware that his current business model is heavily affected by telehealth freedoms enacted during the pandemic. But he also feels the industry has proven itself. They’ve giving lawmakers proof, he said, that value-based care can work.

“The pandemic happened and that switch to telehealth happened,” he said. “I don’t think you can’t not act. To roll back Medicare benefits will be really, extremely difficult.”