Implementing the 3-Day Skilled Nursing Facility Waiver: Key Insights

Area of Science:

• Health Services Research
• Healthcare Management
• Policy Implementation

Background:

• The Centers for Medicare & Medicaid Services (CMS) skilled nursing facility (SNF) 3-day waiver allows Accountable Care Organizations (ACOs) to bypass the traditional 3-day inpatient stay requirement for SNF admissions.
• This waiver facilitates timely access to post-acute care for patients transitioning from various settings, including emergency departments and outpatient services.

Purpose of the Study:

• To report on the implementation experience of the SNF 3-day waiver within an institutional ACO.
• To identify the benefits, barriers, interventions, and outcomes associated with the waiver program for patients and healthcare facilities.

Main Methods:

• The study details the implementation of the SNF 3-day waiver program by an ACO in 2023.
• Data collection focused on process improvements, patient identification, staff education, workflow development, and overall program outcomes.

Main Results:

• Implementation led to streamlined patient access to care and improved healthcare facility efficiency.
• The ACO achieved better management of healthcare utilization and costs.
• Identified barriers included underdeveloped workflows, communication gaps, and patient identification challenges.

Conclusions:

• The SNF 3-day waiver has proven valuable in enhancing patient care and optimizing healthcare delivery within the ACO.
• Continued process refinement and barrier mitigation are essential for the program's long-term effectiveness and sustainability.