Improving post-acute care

May 19, 2016

Post-acute care provider networks are taking on a growing importance for hospital executives, a recent survey of hospital leaders found. 95% of executives surveyed across 82 hospitals agreed, a 5% rise in opinion from last year.

From April 1st 2016, nearly 800 US hospitals began participating in Medicare’s first compulsory payment programme ‘the Comprehensive Care for Joint Replacement’. All costs on discharged patients with hip and knee replacements after 90 days are scrutinised. If all goes well bonuses are offered, but on the other hand, if a patient is re-admitted needing more care, the hospital will receive a penalty.

It is no coincidence this area is being focused on. In a recent Avalere analysis, it was discovered that 39% of total hip and knee replacement expenditure was connected to post-discharge care and hospital readmissions. This area is clearly crying out for better management.

James Garnham, director of contract and payment innovation for University of Rochester Medical Center, has taken the problem very seriously. Garnham formed a large working party of all involved, and created a unified front on fighting the problem.

It worked! Complication figures dropped in the share of joint replacement patients from 74% to just 15%. In addition visits to the emergency departments dropped from 33% of patients to 12%. Interestingly, readmissions were largely unchanged.

This was a brilliant outcome, and one that was implemented and stuck to with little difficulty. The key to its success was ensuring each patient’s care plan was facilitated from start to finish. However Garnham and his team claim they can do better, and are working towards even more favourable numbers.

With the implementation of this model (the ‘CJR’), hospitals are likely to look at their relationships with post-acute care facilities and consider, like Garnham, working more in partnership with each other. This will sharpen up any gaps of care, ensure that complications are kept lower, penalties are avoided and bonuses paid out. Far more importantly though, it ensures patients have a better hospital experience and are put at less risk of complications and errors. Profit from Reputation, by improving risk, cost and the healthcare experience

Posted in Uncategorised by Douglas Fahlbusch