Inpatient rehabilitation programs are confronting more challenges than ever as they enter year two of the pandemic, including sicker patients, extreme regulatory fluctuations, and out-of-control denial rates, all of which require dedicated focus and expertise.
Laird Smithson, SVP and Chief Operating Officer for Kindred Hospital Rehabilitation Services, explores these obstacles, key strategies to overcome them, and the benefits of having a dedicated rehabilitation partner through a joint-venture or acute rehabilitation management.
Q: What are the biggest challenges hospitals and health systems experience with inpatient rehabilitation, and how can they overcome them?
Smithson: The healthcare landscape has never been so tough for providers who run acute rehabilitation programs. Their biggest challenge is driving high-quality outcomes for medically complex patient populations, including those recovering from COVID-19. They are implementing numerous strategies, including enhanced infection control procedures and protocols, new rehabilitation technology for faster recovery, along with specialized education and training to help rehabilitation programs quickly adapt to meet the needs of this new patient population.
At the same time, regulatory compliance oversight is becoming more difficult as rehabilitation programs face increased scrutiny and high denial rates from commercial and public payers, which now deny about one in every 10 submitted claims, according to the Advisory Board. Regulatory compliance requires constant attention, making it all the more important to partner with appeals and denials experts who can improve documentation accuracy and reduce denial rates. Additionally, with continually fluctuating regulations and increasing denial rates, it is critical to streamline patient throughput processes. Organizations are increasingly turning to highly trained clinical liaisons and innovative technologies to help quickly identify the right patients for rehabilitation admission.
Q: What are some benefits of inpatient rehabilitation partnerships?
Smithson: The current strain on America’s health system has led many healthcare providers to partner with dedicated rehabilitation experts. A joint-venture or acute rehabilitation management often results in significant quality improvement, cost savings and optimization for this high-demand service line. In fact, a Deloitte study shows health systems prefer partnerships because they lower post-acute expenditures; enhance overall performance while minimizing up-front costs; increase patient access and employee retention; and offer greater scale and speed to market.
Q: What should hospitals look for in a rehabilitation partner?
Smithson: While the benefits of partnership are clear, not all joint venture or acute rehabilitation management partners are created equal. When evaluating a suitable partner, look for the key qualities that drive long-term success. A prospective partner should have deep experience helping its partners demonstrate clinical effectiveness with reduced readmission rates and better patient outcomes. They must have a proven track record helping their partners adapt to big challenges such as COVID-19, a robust network of medical directors, and a well-organized patient throughput system. A potential partner must also have strong denials and regulatory expertise to stay ahead of the denial trends. For example, denials have recently shifted from orthopedic admissions to shorter stays and 40% of admissions, including nonsurgical admissions such a pelvic fractures, UTI, GI, and metabolic diagnoses. The right partner will have forward thinking technology and a dedicated appeals and denials team.
Q: How do you measure success?
Smithson: At Kindred, we specialize our services to each partner’s unique needs and then measure how we are performing. In addition to our own rigorous set of quality and satisfaction measures, we also partner with a third party, Net Promoter Score™ (NPS). Kindred uses NPS as a key indicator of our ability to deliver on the promises we make to our partners and ultimately patients. In 2020, Kindred reached a “World Class” score, exceeding client experience trailblazers such as Costco and Ritz-Carlton. During the pandemic, there were endless examples of how Kindred’s real-time access to national data and trends enabled us to react quickly to an environment that was changing by the minute and help programs recover faster while maintaining excellent clinical quality.
For more information visit: www.Kindredrehab.com
Kindred Hospital Rehabilitation Services works with more than 300 hospital-based programs nationwide to bring the best possible clinical and operational outcomes.