Published in the December 2014 issue of Today’s Hospitalist
Are hospitalists warming up to the idea of working outside of the hospital in post-acute care? I ask because our cover story this month takes a look at the opportunities “and challenges “of working in SNFs and LTACHs.
Health care these days is buzzing with talk about how to expand episodes of care to encompass both acute and post-acute services. The idea is that hospitalists will play a big role in managing seriously ill patients, and not just in the hospital. Hospital systems and hospitalist organizations alike are recognizing this “and bracing themselves for changes in reimbursement that will likely incorporate this expanded view of patient care.
The problem? Hospitalists have often taken a dim view of post-acute care, particularly when it comes to SNFs. Patient acuity at SNFs is too low to be a good match for hospitalists’ skills, the thinking goes, and the quality of care is not as high as in acute care.
But as our article points out, post-acute care (and hospitalists’ perceptions of it) are changing. We talked to hospitalists who explain that even in SNFs, they see challenging patients. And while the pace of SNFs is different from that of a hospital, these physicians view that as a good thing.
Still, hospitals and hospitalists are struggling to identify exactly how hospitalists should work in post-acute care settings. Should hospitalists work exclusively in SNFs and LTACHs, or should they rotate between post-acute facilities and the hospital? How should they work with nurses, who play a critical role in post-acute care, and how should they be paid?
Those questions remind me of the early days of hospital medicine, when everything was new and up for debate. It will be interesting to see how hospitalists adapt to the brave new world of post-acute care, and how it reshapes the specialty.
Editor & Publisher