Timed Up and Go and Value Based Care: Why They Don’t Play Well Together in Senior Living

Senior living executives want the best for their residents, and that means keeping them out of the hospital. Falls are responsible for sending nearly a million seniors to the hospital each year, leading to a lower quality of life, at best, and death at worst. That’s why preventing falls has always been a key priority for senior living homes.

In addition, preventing falls has also always made good business sense, in part, by helping to maintain residency rates. But now, another business reason for preventing falls appears on the horizon: value based care–a new federal reimbursement model based on improving care and lowering costs.

Senior living and value based care requires better fall monitoring

Value based care is a word that has been kicked around, but hasn’t necessarily come to fruition yet in every senior living home. It is currently a voluntary method of Medicare and Medicaid reimbursement, with providers along the entire continuum of care linking together in partnerships called accountable care organizations (ACOs).

These ACOs are reimbursed according to the money they save in providing better care at lower costs. But soon, ACOs will be the norm and senior living organizations will have to compete for a place in local ACOs, or be left by the wayside.

How will senior living homes compete for a place in an ACO?

One of the main ways senior living homes will compete for market share in the new value based care world will be by preventing hospital readmissions. And the number one way of preventing readmissions is to prevent falls.

Why Timed Up and Go has seen better days

Up until recently the Timed Up and Go (TUG) test has been the gold standard for assessing fall risk in residents; a relatively simple timed test that requires a resident to get up from a chair, walk 3 meters, then turn around, go back and sit down in the chair. But now new research is revealing the shortcomings of TUG. Some say it is too simple to be effective. Others have proven that the assessment of a caregiver is much more accurate. Still others argue that no single test is accurate enough.

Remote monitoring combined with artificial intelligence and ambient “smart” fall risk assessment are changing all that. This new accurate technology can be used in very unobtrusive ways to monitor seniors for fall risk, while helping to maintain quality of life and independence.

TUG doesn’t play well with value based care because value based care is taking care to the next level. Value based care reimbursement is based on quality, measured by statistics. One fall, is one fall too many. In so many ways, it is time to bring fall assessment up to the standards imposed by value based care and ACO participation. Senior living organizations that can think past TUG are going to be setting themselves up for success and setting their senior residents up for longer, healthier lives.

Have you had doubts about TUG? What next steps do you have in mind for fall monitoring during the advent of value based care?

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