Earlier this month, Center for Medicare and Medicaid Innovation's (CMMI) top deputy Adam Boehler announced he may be looking to a bundled payment model for post-acute care (PAC) to save money and improve care. While actual implementation is far from imminent, CMMI's interest in PAC bundles underscores the opportunity to better manage populations with enhanced acute care-PAC partnerships.
Q&A: Unlock the benefits of your post-acute care strategy
This news builds on more than 10 years of momentum for post-acute and acute care collaboration. Initially, the ACA increased incentives for hospitals to work closely with PAC providers. In recent years, readmission penalties, value-based purchasing, and risk-based payment models such as Accountable Care Organizations (ACOs) boosted the importance of aligning post-acute and acute care services. But significant variability in PAC quality and cost, combined with increasingly challenging care transitions, have providers and CMMI alike agreeing that we have yet to realize the full value of these partnerships.
To optimize the efficacy of such networks, population health leaders need actionable data to highlight strengths and pinpoint improvement opportunities across the network. That's why we've created the Post-Acute Care Performance Improvement Assessment. This Excel-based tool pre-populates any hospital's Medicare fee-for-service data to help you evaluate opportunities to improve care transitions and manage PAC performance. Here's our methodology for an effective assessment tool:
A care transitions analysis can identify improvement opportunities in three ways:
Managing a high-performing PAC network is critical to influence downstream care decisions for which hospitals are often held accountable. However, PAC networks fall short when patients do not use their care. In fact, out-of-network utilization can minimize how effectively a high-performing network elevates patient outcomes, improves episodic efficiency, and streamlines cross-setting communication. A good analysis helps you assess if utilization is becoming more concentrated to select facilities over time, whether patients use this narrow network, and how your network is performing as a whole.
Beyond using the network, providers must ensure their partners provide high-quality care. Best practice providers directly compare cost and quality outcomes across their most-used PACs, including quantitative metrics (e.g., length of stay, cost, and readmissions) and qualitative metrics (e.g., preventive care, clinical improvement, safety).
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