Articles-Thought Leadership Five Factors Changing the Delivery of Care | Page 3

“As the march towards value-based payment continues, provider
partnerships are increasingly recognized as a cornerstone to success.
For hospitals and health systems that do not have a full continuum
of care services, formalized partnerships will continue to develop.”
Growth and Partnerships across the Care
Continuum
With greater focus on patient-centered care and the
need for coordination of care across providers and
settings, the industry is seeing more strategic
partnerships among hospitals, post-hospital care
providers, and ACOs. As providers align, they are
creating networks that can coordinate care and
address needs along the entire continuum.
A 2017 Price Waterhouse Coopers study found that
long-term care transactions accounted for 75 of the 219
healthcare deals executed by the end of the second
quarter of 2017, some exceeding $1 billion. These
“megadeals” drive up values even more.
Mergers and acquisitions will result in more narrow
networks and growing clinical integration among
hospitals, physicians, and paraprofessionals. Unique
payor relationships will also develop. These may include
hospital payment for SNF stays and bed-leasing models
to facilitate the timely discharge of hard-to-place
patients to care facilities beyond the hospital walls.
In Becker’s Healthcare Review, consulting firm Health
Dimensions Group predicts, “As the march towards
value-based payment continues, provider partnerships
are increasingly recognized as a cornerstone to
success. For hospitals and health systems that do not
have a full continuum of care services, formalized
partnerships will continue to develop.”
Value-Based Purchasing
Value-based programs from CMS and other payors
now dictate that continuum care providers collect and
report outcomes metrics for greater transparency and
accountability. MedPAC is also advocating for use of
higher quality care providers.
“At discharge from an inpatient stay, the selection
of a provider within a [post-hospital] category can be
crucial because the quality of care varies widely
among providers,” according to a recent MedPAC
statement.
Thomas Mathew, MD, who has served more than ten
years as a hospitalist, palliative care physician and SNF
medical director, is the senior medical director for
naviHealth. In a 2018 interview with Becker’s, he said
hospitals will face challenges identifying high-quality
care continuum providers, explaining that “for every
hospital, there are probably 30-plus home health
agencies, skilled nursing facilities, etc. Some of the
objective quality measures, such as star ratings, often
do not reflect true quality or value.”
In fact, the CMS star rating methodology has been
brought into question. Hospitals and
health systems have long criticized the
CMS star rating system, with Chicago-based
Rush University Medical Center alleging CMS has
miscalculated hospital star ratings since 2016. These
ratings, however, remain the primary indicator for
patients who want to know more about the quality of
care available.
Mathew further asserted that “hospitals need
improved data around actual patient outcomes in as
real time as possible.” He recommends using historical
patient data to group patients with similar functional
assessments and comorbidities. “We can drill down
individual patients and begin to chart their journey.
You can learn so much about the right… care location
for patients—and the right amount of time they need
to be there to prevent readmission—by
understanding a patient’s functional journey through”
the continuum of care.