A clinically integrated network (CIN) client was experiencing significantly higher-than-expected post-acute care costs, driven largely by extended skilled nursing facility (SNF) stays averaging 20–21 days per admission. These prolonged lengths of stay led to increased total cost of care, unnecessary utilization, and added pressure on provider capacity and care coordination teams. Without stronger oversight and more proactive management, the CIN struggled to improve patient transitions, reduce avoidable days, and meet value-based performance targets.
How our Structured SNF Care Management Program Delivered Lower Costs, Shorter Stays, and Higher Quality
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- How our Structured SNF Care Management Program Delivered Lower Costs, Shorter Stays, and Higher Quality
Improving performance in post-acute care is one of the most powerful levers for reducing total cost of care and strengthening value-based outcomes—especially for CINs and risk-bearing organizations. Skilled Nursing Facility (SNF) utilization, in particular, has an outsized impact on both quality and financial performance due to its high cost and wide variation in length of stay.
This case study highlights how our structured SNF Care Management approach helped a CIN gain tighter control over post-acute utilization, reduce unnecessary SNF days, and improve patient experience while operating under global risk. By applying consistent clinical oversight, daily rounding, and coordinated transitions to home health and palliative care, we enabled the organization to drive meaningful cost savings and higher-quality, more efficient post-acute care delivery.
Challenge
Solution
We implemented a comprehensive SNF Care Management Program designed to improve oversight, reduce unnecessary days, and strengthen coordination across the post-acute continuum. The program included daily rounding, systematic utilization review, earlier identification of discharge barriers, and better alignment with home health, palliative care, and community-based resources. By integrating care teams and applying consistent clinical criteria, we helped the CIN reduce avoidable SNF utilization and support safer, more timely transitions back to the home environment.
Results (Within 6 months)
- Reduced average LOS from 21 to 15 days (≤18-day target)
- Achieved 25% reduction in SNF PMPM cost
- Improved outcomes and reduced readmissions
Key Results
Our approach shows that effective post-acute care management can significantly reduce costs and improve quality. Targeting SNF utilization under global risk is one of the highest-impact strategies for improving total cost of care and financial performance.