How to Build an Accountable Post-Acute Network
Quality of care and teamwork across the care continuum have taken on a new level of importance as a variety of structures, from ACOs to readmission rates, force outcomes-based financial accountability on hospitals and health systems.
Post-acute care organizations and the quality of care patients receive there have become such important issues to inpatient-focused organizations that they’re keeping score.
At least, that’s the tactic Altamonte Springs, Florida–based Adventist Health System is using.
Beth Weagraff, corporate vice president of post-acute strategy and implementation, says developing a scoring system for skilled nursing facilities and home health companies used by the 46-hospital, nine-state health system helps focus Adventist on the fact that it’s on a path toward delivering “holistic” care that includes patient interactions with inpatient, outpatient, post-acute, and the physician office.
“We see holistic care as our differentiator, but we recognize that if we’re going to expand the network and improve the product, we’re never going to have enough post-acute assets to do that ourselves,” she says.
Yet among its nine states and 82,000 employees, Adventist does own significant such assets. While following patient choice protocols, the system refers patients to both owned and non-owned post-acute providers, in varying volumes, depending on the city, state, or region where it has a presence.
That means it needed a fair way to recommend options for where patients should continue their care following an inpatient discharge, which is where Weagraff and her colleagues sought help to develop a survey and scoring system to refine and incentivize post-acute network partners.
Quantifying quality and cooperation
In late 2016, Adventist began to work with a consultant to begin to construct a framework that incorporated quantitative and qualitative metrics to rank post-acute partners in a way that was agnostic as to whether the partner was an Adventist-owned asset.
CMS star ratings are among the data points, as are individual partners’ readmission rates and variation and improvement on patient outcomes. Scoring well on these criteria qualified that organization for a site visit for further evaluation.