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Get Your Seat at the Table Today!
Can’t sleep?
Rest assured, you have
The time is now to execute on initiatives to optimize patient care and
demonstrate positive outcomes
A
ccountable Care Organization (ACO) networks and bundled payment programs continue to gain
momentum throughout New York and across the nation. As such, these influential networks
(inclusive of physician groups, hospital systems, managed care, etc.) are becoming more influential and
even more refined.
Every Post-Acute Care (PAC) provider must be considering strategies to link elbows with referral sources,
ACO/bundled payment networks, managed care networks and regional conveners. After all, the climate
has changed quickly and dramatically; consider the startling statistics:
• Currently, one in ten Medicare beneficiaries are attributed to an ACO
• 50 percent of all payments this year will be via a value-based program
• 90 percent of Fee-For-Service (FFS) Managed Care Alternative (MCA) dollars are linked to
quality or value
The impact of these health care reform mandates speak volumes! They suggest that this shift will
continue to gain momentum. For example, several studies demonstrate the percentage of bundled
payment patients discharged from the hospital setting directly to a skilled nursing facility has dropped as
much as 30 – 50 percent for orthopedic and cardiac valve replacement surgeries.
High Expectations!
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Becoming part of a preferred network or bundled payment program is critical to PAC providers’ survival,
but it comes with a price: high expectations!
GU
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RISI TS
COS
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MEN
RSE
IMBU
QUALITY
LeadingAge New York Services developed Solutions to help you stay competitive
even in this challenging environment. Our suite of comprehensive, integrated,
competitively-priced solutions is just a phone call away. Whatever is keeping you
awake at night, don’t count sheep, count on us.
Contact Holly Smith at 518.867.8383 TODAY!
7
Adviser a publication of LeadingAge New York | Spring 2016
Healthcare organizations and networks are seeking only strategic partnerships that will help them
to remain financially viable. As such, it is imperative for PAC operators to not only understand these
expectations, but to also execute on processes, programs and plans in support of these important strategic
changes as soon as possible. The following discussion encourages swift and smart execution on three
critical drivers: quality patient care, monitored performance metrics and tactical operational changes.
Patient Care is Paramount
The Centers for Medicare and Medicatid Serices (CMS) focus on the “Triple Aim” initiative, dictates
whether many PAC facilities will survive the healthcare reform transition. There is a universal sense
of urgency related to adopting internal care designs to improve quality patient care and satisfaction,
improve the health of populations, and to reduce the per capita cost of health care. The “Six Aims for
Improvement” defines “ideal healthcare delivery” and PAC providers must be prepared to demonstrate
their efforts to align with each of the six quality indicators, which state that care should always be:
• Timely: Steps must be taken to avoid delays in care; arrange for consistent weekend/holiday coverage.
• Efficient: What processes are in place to optimize use of supplies, equipment?
• Equitable: Delivery of high quality PAC services should be available to all.
• Safe: Patients must not be harmed by the system; particularly at vulnerable transitions of care.
• Effective: Evidence-based care (as with pathways/protocols) must be put into place.
• Patient-Centered: Patients must have an active role in care decisions, and specific needs (social or
cultural) be determined/communicated at each PAC transition.
Moreover, “in-network” providers are expected to embrace INTERACT, or a similar program to track,
manage and report out on a comprehensive admission, discharge planning and communication processes
related to care transitions. Often times, although a PAC operator understands the value of INTERACT,
implementati ۈ\