Hospital leaders share care continuum strategies

Hospital leaders discussed their individual organizations' strategies for integrating post-acute providers such as skilled nursing facilities into the care continuum as part of a panel discussion Tuesday at U.S. News & World Report's Hospital of Tomorrow conference.

In a post-Affordable Care Act medical landscape, providers have an incentive "to reach out to our various skilled nursing facility providers… in different ways and have different conversations than we've really ever had before," said moderator Brian Fuller, director of Avalere Health in the District of Columbia. "Wherever your organization is in this continuum, you have some skin in the game."

Hospital executives are beginning to prioritize discussions of post-acute care, Fuller said, after historically focusing more on hospital settings and organizing physician networks.

For example, MissionPoint Health Partners in Nashville operates as a clinically integrated network, said MissionPoint Chief Medical and Chief Integration Officer Jordan Asher, M.D., working with various kinds of facilities, including long-term care, to "coordinate that care in a way that creates clinically integrated systems of care. The organization aims to lower costs, improve patient health and the patient experience, and enrich the lives of caregivers through its care coordination efforts, he said. 

Post-acute care figures heavily into value-based payment models such as accountable care organizations, Asher said. "We analyzed our MSSP [Medicare Shared Savings Program] data; in fact, the post-acute care…accounts for about 26 percent of our spent [money], which is the second largest, so therefore, after reducing admissions, that is the biggest place I'm looking at."

Kelvin A. Baggett, M.D., senior vice president of clinical operations and chief clinical officer for Tenet Healthcare in Dallas, described the expansion of his organization in recent years, such as its acquisition last year of Vanguard Health Systems, as a deliberate effort to increase its focus on patient outcomes.

 "If we want to be outcomes-focused … we have to expand not only our relationships but our presence beyond the acute care environment," Baggett said. "[B]y being successful we not only contribute to the health of those patients in which we exist, we also hopefully create some models of shared learning for others as well."