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Recognizing the Value of Postacute Care Partners

By Mike Beaty

Pressure to produce better clinical outcomes and reduce costs prompts providers to select postacute partners carefully and integrate them into their overall care strategy.

It's a whole new world in health care that's full of promise as well as demands. Through initiatives such as the Medicare Access and CHIP Reauthorization Act of 2015, the federal government continues to indicate its future direction with the industry—paying for value rather than volume of care. Additionally, providers will be asked to navigate exacting incentive programs that tie payments directly to quality.

The move toward an integrated value-focused delivery system requires hospitals to collaborate seamlessly with postacute care (PAC) partners in providing well-coordinated care. With increasing pressure to deliver better clinical outcomes and reduce costs, it is clear that acute care providers will need to select their postacute partners carefully and integrate them into their overall care strategy.

"Collaborating closely with PAC partners helps get patients into the right setting after their hospital stay and raises the likelihood of their swift recovery," says Henry Allen, MD, an internal medicine specialist named one of the "top docs" of the Dallas-Fort Worth area. "Working together, acute and postacute providers can achieve an appropriate length of stay for each patient, reduce hospital readmissions, and improve care efficiencies."

Delivering Accountable Care
According to Allen, delivering accountable care is an imperative for health care providers. The two pillars of accountable care, he explains, are fiscal responsibility and quantitative quality.

"When I started practicing medicine in the early '90s, the health care community was not subject to metrics the way it is now. Although quality has always been an important goal for any individual or institutional provider, we didn't until recently have an objective methodology for measuring and pursuing it. Today we have metrics that can help us gauge quality, find variations in practice, and continuously improve our processes," Allen says.

Determining the Role of Postacute Partners
"The patient's care experience doesn't end when he or she is discharged from the hospital," Allen says. "It continues as the patient transitions to the next care setting. Continuity is the key to effective care because physicians see patients in the hospital and in the PAC setting. We need to know exactly what's going on with each patient at every point in the care continuum."

Hospitals need to collaborate with PAC providers to standardize processes so that patients are not subject to haphazard care and random results, he explains. "Delivering consistently good outcomes requires providers to have greater oversight in the postacute 'voyage to value,' where much of the variability in care can emerge."

Developing a PAC Network
The overarching criterion for choosing the right PAC partner is by far its track record in quality, Allen says. The Improving Medicare Post-Acute Care Transformation Act of 2014, known as the IMPACT Act, requires PAC providers to submit standardized data on quality measures to help facilitate coordinated care and better outcomes. There will be transparency as the reported results will be shared publicly.

"It's vital to look for partners who are proactive, not reactive, in implementing care metrics and using consistent standards for specific disease management," he says. One of the most common metrics for evaluating PAC providers, he explains, is readmission rate, or how many patients under their care end up back in the hospital. Other contributing factors can include the incidence of major falls or inadequate medication reconciliation.

According to Allen, PAC facilities vary greatly in their ability to provide and gauge quality. He offers an example from his market of a PAC provider uniformly proactive in delivering and measuring accountable care: StoneGate Senior Living, with facilities in Texas, Colorado, and Oklahoma. StoneGate's secret to success lies in "having in place the right mission, the right vision, and the right values. This foundation empowers the care team to practice evidence-based medicine, leading to optimum patient outcomes and return to function."

Defining the Future of Care
Allen predicts that this movement toward value-based care is only the beginning of the changes in store for the health care industry. In the years ahead, he envisions that care will be more transparent, standardized, and consequently, more accountable. This will be evidenced by seamless care delivery in every setting. Outcomes will be easier to measure than they are today. Payment for care will be vigorously responsible and tied directly to quality. Acute care and PAC providers will partner effectively, resulting in improved understanding and measuring of a patient's experience.

"The picture of tomorrow is one of profound transformation, taking providers to an even deeper dimension in fulfilling their missions. Ultimately we are remodeling a 'sick care' system into one that delivers true health care—highly collaborative, exceptionally efficient, and relentlessly patient centered," Allen says.

— Mike Beaty is vice president of provider relations at StoneGate Senior Living in Lewisville, Texas. With more than 30 years of health care experience, he focuses on strategic partnerships between acute care, physician, and managed care.