To maximize payments, nursing homes don’t necessarily need to deploy more technology but instead make better use of existing software, especially clinical dashboards, which are currently underutilized.

Data derived from clinical dashboards can prevent attrition of payment. And, more widespread use of clinical dashboards should be a standard practice across nursing homes, according to Danielle Dang , VP of Clinical Reimbursement at EF Senior Care, given their many benefits for payment, workflows, management of acuity and performance on surveys.

When regional nurses receive monthly performance reports from Directors of Nursing (DNSs), the data is more reliable when it is pulled directly from the organization’s dashboards rather than manually compiled by clinical staff, Dang explained.

Moreover, the data from clinical dashboards is also easily replicated so that if a surveyor, for example, questions a metric, the organization can go back to the underlying system and documentation to verify it.

And aside from minimizing mistakes, if dashboards are the official source of performance data, administrators and Directors of Nursing (DONs) can be held accountable for reviewing and acting on those metrics.

“Your administrators and DON should be using their dashboards and their tools on a daily basis and be driving their day from it,” said Dang. “There’s no point in having all of this great data if people are not using it for those critical things.”

Meanwhile, clinical dashboards can also allow a facility to use its data to see that a particular Medicare Advantage payer has residents with higher acuity, requires more authorization work, generates more claim touches, or produces slower payments, Elizabeth McLaren, VP of Revenue Cycle Reimbursement and HCBS at Covenant Living Communities and Services, told Skilled Nursing News. That gives the SNF a much better picture of the true financial impact of that payer than simply looking at the contracted daily rate.

Dang recommended that revenue-cycle leaders use dashboards to monitor net revenue per patient, estimated pharmacy costs, length of stay, rehospitalization rates, and accounts-receivable aging by payer. Together, these metrics can give SNFs a clearer view of payer performance, resident costs, payment trends and potential financial or operational issues, she said.

Recommendation for technology investments

Beyond underused clinical dashboards, integrating and using existing AI tools and software already in place can go a long way in curtailing unnecessary costs.

“Something that we’re kind of more focused on within Covenant right now is really looking at what [tech] do we have, how is it being used, and is it optimized? Because I guarantee that most providers already have a lot of this technology. It’s either not being used or not used appropriately,” said McLaren.

That said, the technology investment to make room for in the 2027 reimbursement environment would be tools that enable visibility and integration.

SNFs need systems that communicate with one another, particularly clinical and financial systems, so organizations can better understand payer performance, reimbursement rates, administrative burden and claim-processing efficiency.

She emphasized the value of understanding the true operational cost of different payers, including how many times staff must touch a claim before it is paid.

In other words, don’t evaluate a payer solely by its reimbursement rate, McLaren said. Instead, use integrated technology and data to understand the full financial and administrative cost of working with that payer.

“Some of our data that we’ve pulled recently from submission to claim adjudication – it’s seven times that our team is having to touch that claim. That’s a ridiculous multiplier,” McLaren said.

Organizations should establish who is responsible for different processes and ensure staff are actually using the systems effectively, McLaren said, cautioning that adding new technology does not automatically improve operations and can create extra work.

“If we have a sales team who is spending more of their time documenting … than they are meeting with potential referral partners and bringing in referrals and admissions, we have a problem with our process. And so, I think technology is a great way to gather that data,” she said. 

The ultimate goal is to use technology to create greater visibility into operations and payer performance while reducing unnecessary administrative work.

“[Have] visibility into payer performance … what is it looking like? What are these rates? What is the difference? What is the administrative burden difference between fee-for-service Medicare, Medicare Advantage, Medicaid, for example?” she asked, suggesting training staffing to fully understand the data and even know how many times a facilities team has to touch a claim before it gets paid.