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How Postacute Care is Evolving

By Christopher Cheney  
   December 14, 2015

Brian Holzer, MD, MBA

"The aspiration two years ago was to test a provider-driven, postacute care network," Holzer says of AHN's strategy for Healthcare@Home, noting nonproprietary partnerships with SNFs are a crucial element of the health system's grand plan for postacute care. "We do not own SNF resources. We partner with a select number of skilled nursing facilities."

AHN's SNF partners have agreed to hire highly skilled nurses to boost quality at their facilities, he says.

"We request the skilled facilities to appoint nurse practitioners to round with our patients to make sure the clinical quality meets our clinical standards. The SNFs that believe in their capabilities are welcoming this step. They see this relationship as a way to sustain their volume. It's been an incredible journey already."

While acknowledging that clinical quality at SNFs has been a weak point in the healthcare industry for decades, Holzer says establishing mutually gainful partnerships between hospitals and SNFs has the potential to fundamentally transform the care provided to older patients with multiple chronic conditions. The benefits of this transformation will be not only clinically healthier patients but also financially healthier SNFs, he says.

"We hold SNFs to standards. They know if they don't meet our standards, we can go out and find someone else who will. They know this is a path to their sustainability. We are agreeing to collaborate to create a better model of care. Beating down on SNFs and putting them out of business is not the right approach. Our approach, which provides a large amount of volume, allows them to invest in themselves and get better."

Skilled nursing facility perspective
The drive to increase collaboration between hospitals and SNFs is closely linked to the healthcare industry's shift away from fee-for-service payment models, says Lisa Thomson, chief marketing and strategy officer at White Bear Lake, Minnesota–based Pathway Health Services, a professional management and consulting organization serving clients in the long-term care and postacute care industry.

"It's a tipping point now as we move to value-based payment. It's a paradigm shift for the skilled nursing facilities," she says.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


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