This is part two of a two-part series about our recent Care Coordination summit in Detroit. You can read part one – covering the benefits of performing a preferred provider network – here.
One of the highlights of the event was a panel discussion about what it’s like to be on the front lines at a hospital building a preferred provider network. Our panel included representatives from a small hospital, a medium-sized hospital and a large health system. Sally Bailey, former Manager of Case Management and Utilization at Beaumont Health – Wayne Hospital, and one of the panelists, discussed how she implemented a network to manage costs, ensure CMS reimbursement and enhance patient care.
Payment models are increasingly focused on reducing the total cost of care and providing incentives for all providers across the health care continuum to work together to manage patients. Medicare spending on PAC services has experienced exponential increase relative to overall Medicare spend. With the understanding that post-acute care is an integral component of payment and delivery system reform efforts, Beaumont sought to build a preferred provider network of skilled nursing facilities (SNFs) for cost and quality management.
At the outset, certain parameters and metrics were established to get every provider on the same page. To effectively manage the partnership program, accountability had to be shared across providers. For the Beaumont network, that meant:
- Open communication pre and post-transition
- Integration of metrics for quality reporting
- Tracking readmissions from SNFs
- Measuring SNFs average length of stay (ALOS)
To do all of this and automate reporting and alerts, Beaumont invested in the CarePort platform. The technology made it easier to follow patients throughout the network, and track outcomes for patients and providers. Bailey shared how Beaumont leveraged CarePort Health solutions to implement the new program.
- Case managers were equipped with iPads to use CarePort Guide interactively with patients and families to keep patients in the preferred and high-quality post-acute network
- Alerts from CarePort Connect allowed case managers to receive real-time notification when patients transferred from SNF to ED (and to intervene in the ED prior to readmission)
- CarePort Insight streamlined data collection from post-acute providers for monthly metrics reviews
A trusted post-acute preferred provider network, powered with the right technology, is the foundation that allow health systems to better pursue the Triple Aim. Click here to read how other organizations have used CarePort to help establish provider networks and streamline care coordination.
