As newer care delivery models evolve and emerge amid healthcare's transition from volume to value-based care, post-acute care (PAC) providers have a vital role to play, according to a new TrendWatch report from the American Hospital Association.
In recent years, larger percentages of Medicare patients are discharged to PAC settings, according to the report; for example, 17.3 percent were discharged to skilled nursing facilities in 2008, compared to 19.5 percent in 2013.
The increased proliferation of alternative payment models that involve shared risk among hospitals, PAC providers and insurers means PAC providers must understand factors such as geographic PAC spending variation. This variation is due to several drivers, including broad variation in conditions, comorbidities and medical severity; volume of patients discharged to PAC settings after short stays in acute hospital settings; and the amount and category of PAC services received during the care episode.
Major PAC providers have already made strides in improving or creating business models to make them better suited to a value-based care system. For example, RML Specialty Hospital, a Chicago long-term care hospital, focuses its ACOs' resources on highly-specialized care for patients admitted directly from a hospital and who needed three days in an intensive care unit. RML also has joined multiple PAC continuing care networks, and is currently tracking data on patients discharged from the hospital for 180 days, which it will then use to compare the outcomes to those of patients discharged from other types of post-acute providers.
Meanwhile, Brooks Rehabilitation, an inpatient rehab facility in Jacksonville, Florida, redesigned its care model that emphasizes four patient needs:
- Selecting the right first setting by finding the least expensive PAC setting that meets a patient's needs
- Standardizing care across settings so patient outcome measures are comparable no matter where the patient receives care
- Planning for longitudinal care that results in a two-month care plan that accounts for patient needs in every care setting
- Appointing nurse care navigators who aid patients in a coordinated transition from one setting to the next
To learn more:
- download the report (.pdf)