Over the past five years, North Shore-LIJ's leadership team has been expanding the organization's postacute care capabilities beyond the integrated health system, Siegel says. The primary focus of that effort has been creating partnerships with approximately 20 independent SNFs to meet demand for long-term care services. "We realized that we needed to partner with other facilities."
North Shore-LIJ does not have an ownership stake in the health system's off-campus SNF partners, but several metrics are monitored at the affiliates, including Medicare Nursing Home Compare star ratings, readmission and mortality rates, department of health surveys, and length of stay, she says.
"We are using the metrics to evaluate the affiliates. We are trying to move our patients to the best facilities. We collect data from all of our affiliates. As everything moves to capitation and bundled payments, it is really important that we have these relationships," Siegel says, noting length of stay at SNFs is already a crucial factor in bundled payment contracting. Length of stay will become increasingly important as the Centers for Medicare & Medicaid Services and commercial payers roll out new value-based payment models, she says. "There will be financial implications for healthcare systems and skilled nursing facilities."
Pittsburgh-based Allegheny Health Network, which has eight hospitals and 17,500 employees, does not own any SNFs, but has been boosting its postacute care capabilities over the past two years, says Brian Holzer, MD, MBA, senior vice president of home and community services.
"We are using the metrics to evaluate the affiliates. We are trying to move our patients to the best facilities."
Under the Healthcare@Home brand launched in April, AHN is developing "a postacute care model focused on home health," Holzer says, noting the service pillars of the model include hospice, home health, palliative care, home infusion, and home medical equipment and supply sales. Healthcare@Home also includes transitional care, a coordinated care model focused on discharge planning and postacute care follow-up with patients that Naylor has helped develop over the past 20 years.
Christopher Cheney is the senior clinical care editor at HealthLeaders.