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The central role of partnerships in care management—and where suppliers and service providers fit in

July 6, 2017

    Regardless of how quickly an organization is moving toward population health, partnerships with post-acute care providers, community organizations, and health plans will be critical to success. Here's how:

    Post-acute care providers

    Traditionally, hospitals and post-acute care sites—such as skilled nursing facilities and inpatient rehabilitation facilities—have struggled to communicate effectively. This has often led to disjointed care and preventable hospital readmissions.

    To address this problem, CMS has implemented various value-based care initiatives that financially incentivize providers to ensure delivery of quality care across the continuum.

    In an effort to guarantee high-quality care, hospitals have been cultivating post-acute care networks of affiliated "preferred providers." These networks have the potential to benefit all parties involved: When effectively utilized, they can improve patient outcomes and experience, benefiting patients and hospital-based providers. And they can increase patient referral streams, benefiting post-acute providers. While the Stark Law restricts providers' ability to self-refer patients, hospitals invest in partnerships by enhancing avenues of communication and collaboration with their partner institutions.

    Partnership between hospitals and post-acute providers not only presents an opportunity for industry involvement—it practically hinges on it. Here's how you can play a role:

    • Data tracking and management. Hospital providers decide who to partner with based on post-acute care provider data on quality of care. Emphasize how your product or service can drive quality of care for organizations that you already work with—it may allow you a foot in the door for their partner institutions.

    • Communication. Partnerships rely on strong communication to facilitate care transitions. Streamlined communication tools that embed within and can jump across EHR systems are hugely beneficial. They can limit workflow interruption associated with collaborating across sites of care, and reduce communication-based care errors.

    A word of caution: When making these investments, provider organizations will home in on ROI—you must be able to make a strong case for your product or service. Consider how you can help improve provider quality and operational efficiency, and/or offer cost savings.

    Community organizations

    Managing a population requires addressing both clinical and non-clinical factors related to health. That's why progressive population health managers are investing in community partnerships intended to address determinants of health that fall outside the purview of a traditional care setting, but that can have both short-term and long-term impacts. Suppliers and service providers should consider these partnerships an essential piece to their provider clients' overall investments in population health.

    Not all community partnerships provide fodder for industry involvement, but that doesn't mean you should write off participation in community partnerships all together. For organizations looking to take the next step to support your clients, there are a few ways to do so:

    • Find the areas where your services can benefit provider-community partner relations. Can you provide educational material about your product that may give context to community-based organizations supporting care management for relevant patient populations?

    • Alternatively, tap into the mission of select clients' partner organizations and think about how your product or service can impact patient outcomes. If your pharmaceuticals need to be taken with food, can you work with a food security non-profit to identify at-risk populations based on your patient demographics? Not only can this type of partnership improve quality outcomes to support the community-based organization's mission, it can enhance your relationship with providers in the market whose patients benefit from these services.

    Health plans

    Finally, providers are also partnering with health plans. By pooling financial risk among both entities, providers and plans are incentivized to effectively manage population health and ensure patients appropriately use preventative services. Partnerships range from new efforts around care coordination and care management to full partnership around health plan products.

    When providers take on or share responsibilities with health plans, it may affect their relationships with industry players. Plan stakeholders may become more involved in purchasing decisions, especially when it comes to capital purchases such system-wide IT platforms. Outside of the role of the plan stakeholder, purchasing decisions could be affected by plan performance. Here's what you should do:

    • To win plan stakeholders over, show how your product or service fits into a population health-focused strategy.

    • To prevent sticky purchasing situations resulting from poorer-than-expected plan performance, make sure your contracts are air-tight and carefully consider whether contractual flexibility is a viable selling point for your organization.

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