According to a nursing home resident research, the lack of physician coverage during off hours (such as weeknights and weekends) might be one of the causes for unnecessary emergency room visits and hospitalizations. With the growing telemedicine developments and adoption by health care organizations, researchers are exploring whether the use of telemedicine in off hours can result in less hospitalizations among nursing home residents. The results of a recent telemedicine study found that the nursing homes who had an engaged use of telemedicine saw a lower rate of hospitalization, compared to residents of nursing homes without telemedicine access.
The nursing homes with more engaged use of telemedicine in off hours reduced hospitalization rates by 11.3 percent compared to 5.2 percent in the facilities with less engagement. While these are encouraging results, the business case for nursing home adoption of such technology does not exist. Specifically, the following disincentives are currently present:
- Telemedicine service is an additional expense to nursing homes, and it is not reimbursable by most health care payers (e.g., Medicare, Medicaid, private insurers)
- Savings from reduced hospitalizations accrue to health care payers and not the nursing homes
Policy changes and innovations in nursing home financing schemes are needed to encourage adoption of technologies that can result in more efficient use of health care services. For example, extending the accountable care organization model to include skilled nursing care, and coordinating payments across health care settings, may increase accountability for the quality, costs, and overall care for the nursing home residents.