The Claimocity Blog
SNFist:
The Rising Star of Inpatient Medical Specialties
What is an SNFist?
A SNFist, also known as a SNF-ist or SNFologist, is a physician specializing in senior or recovering patient care mainly within Skilled Nursing Facilities (SNFs), dedicating 80-90% of billing claims to nursing home care. Like hospitalists, they work in diverse settings such as inpatient rehab facilities (IRFs), long-term acute care hospitals (LTACHs), and conventional SNFs. While the term “SNFist” emerged about six years ago, a standardized definition from the Center for Medicare and Medicaid Services (CMS) is yet to be established.
Primary specialties of SNFists include physical medicine and rehabilitation (PM&R or Physiatry), geriatric medicine, geriatric psychiatry, and palliative care. Additional specialists may visit associated facilities as required for specialized treatment and diagnostics.
Numerous studies underscore the vital role of SNFists in reducing preventable hospital readmissions and improving patient outcomes compared to generalist physicians.
SNFists vs Hospitalists
Hospitalists and SNFists differ primarily in their practice settings and medical specialties. SNFists mainly work in post-acute care facilities, while hospitalists are centered in acute care hospitals. Additionally, SNFists represent a few specialties, whereas hospitalists cover a wide range of specialties and sub-specialties. This divergence highlights the distinct roles and expertise within each profession.
Software and Billing Solutions for SNFists
Similar to hospitalists, SNFists, contracted at skilled nursing facilities and other settings, heavily rely on billing solutions. Over 80% of SNFists opt for outsourced billing services due to the challenges and costs of maintaining an in-house team. SNFists also require software that integrates seamlessly with the predominant EHR systems used in skilled nursing facilities: PointClickCare (PCC) with a 70-80% market share and MatrixCare, which, following the acquisition of SigmaCare, controls the majority of the remaining 20-30%. This integration is vital for efficient workflow and accurate patient documentation within the facility’s chosen EHR platform.
Enhanced Integration with PCC and MatrixCare
Numerous charge capture, practice management, and billing software systems collaborate with PCC and/or MatrixCare for integrated solutions. However, Claimocity is the premier integration partnership, enabling direct pulling and pushing of progress notes into the EHR system. This coded data flow facilitates real-time updates across both systems, streamlining workflow and eliminating manual data entry. This advanced connectivity not only saves time by automating patient data input but also enables seamless progress notes integration and simultaneous billing and charting at the point of care, enhancing efficiency and reducing administrative burdens.
Challenges of Using a Secondary EHR
Many SNFist practices use a secondary EHR for charting before transferring data to the facility’s primary EHR. While this offers convenience and quality assurance, it brings significant downsides. Apart from the high monthly cost, there’s an increased risk of data loss, exposure, and liability. Transferring data between systems introduces human error and security vulnerabilities, with potential legal implications. Thus, relying on a secondary EHR adds complexity and risk for SNFist practices.
Software and Billing Solutions for SNFists
Similar to hospitalists, SNFists, contracted at skilled nursing facilities and other settings, heavily rely on billing solutions. Over 80% of SNFists opt for outsourced billing services due to the challenges and costs of maintaining an in-house team. SNFists also require software that integrates seamlessly with the predominant EHR systems used in skilled nursing facilities: PointClickCare (PCC) with a 70-80% market share and MatrixCare, which, following the acquisition of SigmaCare, controls the majority of the remaining 20-30%. This integration is vital for efficient workflow and accurate patient documentation within the facility’s chosen EHR platform.
SNFists Help Reduce Hospital Readmissions
Recent data science trends and forecasts highlight the significant role SNFists play in reducing hospital readmission rates, particularly among elderly patients with multiple comorbidities. Studies indicate that a quarter of hospital admissions could have been prevented with better care in home, outpatient, skilled nursing, or related facilities.
By providing proactive care to at-risk seniors outside the hospital, SNFists can prevent unnecessary readmissions for conditions like urinary tract infections and pneumonia. Unlike ambulatory care physicians who typically visit nursing home patients monthly, SNFists engage with patients daily or weekly, enhancing continuity of care and reducing the likelihood of hospital readmissions.
Growth Trends and Research Findings
There’s a noticeable trend in nursing homes towards admitting higher acuity patients. This shift creates a growing demand for SNF-focused specialist physicians who can cater to these patients without navigating the hurdles often found in corporate medicine and hospital high acuity units (HAU). Instead, these specialists can play a pivotal role in treating higher acuity patients within the facility’s protocols, which prioritize both provider and patient needs.
Numerous scientific studies have examined the role of SNF physicians in delivering care to skilled nursing facility patients. Below are a few examples:
- Journal of the American Medical Directors Association (2016): Researchers examined the impact of SNF physicians on hospital readmissions among Medicare beneficiaries. The study found that patients who received care from an SNF physician had a lower risk of hospital readmission compared to those who did not receive care from an SNF physician.
- Journal of the American Geriatrics Society (2019): Examining the role of SNF physicians in managing pain in patients with dementia. The study found that SNF physicians played a crucial role in assessing and managing pain in these patients, which led to improved quality of life and reduced caregiver burden.
- American Medical Directors Association (2020): This study examined the impact of SNF physicians on the use of antipsychotic medications in patients with dementia. The study found that SNF physicians were able to reduce the use of these medications, which are associated with increased risk of adverse events and mortality, by providing alternative treatments and addressing underlying causes of behavioral symptoms.
- Journal of American Medical Directors (2015): This study surveyed medical directors of skilled nursing facilities and found that having a dedicated SNFist led to improved patient outcomes and reduced hospital readmissions.
- American Geriatric Society (2016): In an article titled “Outcomes of Skilled Nursing Facility Residents Treated by a Geriatrician or Generalist Physician: A Propensity Score Analysis,” this study compared outcomes for skilled nursing facility residents treated by either a geriatrician or a generalist physician and found that those treated by a geriatrician had better outcomes, including lower hospital readmission rates and higher functional independence.
- JAMDA (2017): In an article titled “The Skilled Nursing Facilityist: A Model for Post-Acute Care Coordination” the SNFist model of care and its benefits was explored, including improved communication and coordination of care between providers, reduced hospital readmissions, and improved patient outcomes.
- Journal of Hospital Medicine (2018): A scientific study called the “Impact of Skilled Nursing Facilityists on Hospital Readmissions for Patients Receiving Post-Acute Care” found that skilled nursing facilities with dedicated SNFists had lower hospital readmission rates for patients receiving post-acute care.
Collectively, these studies underscore the critical role of SNF physicians in enhancing outcomes and lowering healthcare expenses.
