In today’s intense healthcare environment, collaboration between acute and post-acute providers as well as payors has been particularly essential.
Recent analysis conducted by ATI Advisory, a Washington, DC-based research and advisory services firm, evaluated post-acute provider performance during the public health emergency using claims data from Centers for Medicare and Medicaid Services (CMS).
This article outlines the key findings of the resulting study Role of LTAC Hospitals in COVID-19 Pandemic that reinforce the positive outcomes of long-term acute care hospital (LTACH) partnership.
The Value of Partnership for a Niche Patient Population
The ATI Advisory study highlights that, during the pandemic, strong communication and partnerships between acute hospitals and LTACHs were critical in managing COVID and non-COVID patients: “[Short-term acute care hospitals (STACHs)] turned to LTACHs to relieve capacity constraints and admit and support, without disruption, patients with more intensive needs.”
The value that LTACHs brought to managed care plans and their patients was also emphasized in the report. Specifically, it noted that “LTACHs that appropriately redesigned processes during the pandemic were able to (a) deliver better COVID-specific care and (b) highlight the LTACH model’s unique capabilities.”
As the benefits of transparency and collaboration are becoming more apparent due to the pandemic, payors should continue to ensure their partners are meeting these expectations.
LTACH Population Is Becoming More Acute, Even with Waivers
While the temporary prior authorization relief has expired in many areas, it is important for managed care organizations to recognize that it encouraged flexible care pathways between STACHs and post-acute care settings. The waivers enabled STACHs to improve patient flow and minimized unnecessary disease exposure (COVID-19 and otherwise) through shorter lengths of stay. The streamlined process also resulted in improved care and outcomes for LTACH-appropriate patients.
According to the report, CMS claims indicate that LTACHs remained a specialty setting for the sickest patients. Despite federal waivers that loosened stringent requirements for LTACH admission, LTACHs cared for an even more complex patient population during the COVID-19 pandemic, as supported by an increased Case Mix Index (CMI) from January to May 2020.
Also within the study, the shorter average length of stay (ALOS) at an LTACH compared to other post-acute care providers was recognized as a differentiator. One VP of Population Health Management at a Managed Care Plan stated, “If a patient is going to a SNF but staying 45 days and would have only stayed 20 in the LTACH and then gets discharged home, that’s probably a better outcome.”
As patients become more medically complex, payors should ensure their networks include the specialized, effective care settings these patients require.
The Benefits of LTACHs Within Payor Partnerships
Going forward, the study indicated that “LTACHs can leverage their meaningful role during COVID-19 in order to foster new conversations with plans and policymakers to share metrics, increase transparency, and collaboratively develop new patient pathways that reduce friction during patient transitions.”
Providers and physicians interviewed by ATI Advisory collectively indicated that the capabilities of LTACHs extend the capacity of short-term hospitals as well as deliver a particularly helpful clinical expertise for a COVID-19 population – that of treating patients on a ventilator or in respiratory failure.
The COVID-19 pandemic has highlighted shortfalls in our nation’s healthcare system, yet it has also provided opportunity for providers to collaborate in new ways and has underlined the value of LTACHs in caring for the most critically ill patients, including those with COVID-19.
How Kindred Can Help Manage Your Medically Complex Patient Population
Acute care providers and payors need partners who can provide the physician-directed care these medically complex patients require.
Kindred Hospitals specialize in the treatment of patients needing intensive care and specialized rehabilitation in an acute hospital setting.
With daily physician oversight, ICU- and CCU-level staffing, 24/7 respiratory coverage and specially-trained caregivers, Kindred Hospitals improve functional outcomes, reduce costly readmissions and help patients transition home or to a lower level of care.
Throughout the pandemic, Kindred Hospitals have proved to be a key partner in decompressing ICUs. Kindred Hospitals also demonstrated integrity by maintaining a commitment to treating only medically complex patients, despite the removal of prior authorization that could have allowed for admission of patients who would benefit from a lower level of care.
Kindred Hospitals offer health plan partnerships that are customized by product and can be built on DRG or negotiated by per diem rates.
Visit kindredmanagedcare.com to request a conversation about how Kindred Hospital’s level of service can help manage your critically complex patients.
Dr. Sean Muldoon, SVP, CMO for Kindred Healthcare’s Hospital Division, oversees clinical care oversight, medical staff affairs, and strategic relationships.