Recently, CarePort Health held a Care Coordination Summit in Detroit, Michigan, where local leaders in care transformation came together to share their challenges and ideas. This post is the first in a two-part series that covers our discussions at the summit.
CarePort CEO Dr. Lissy Hu began the event with an update on value-based care across the country, and how the goals have changed. For example, the hospital’s responsibility used to end at making sure patients had services or a skilled nursing facility (SNF) bed available upon discharge from the hospital. Now, health systems need to think about the quality of care at various facilities in order to reduce the risk of a readmission.
Forming preferred provider networks can generate improvements in patient health outcomes and total cost of care. In a recent survey published in NEJM Catalyst, 375 hospitals were asked to select the top benefits of having a preferred post-acute provider network. More than half (55%) of hospitals reported that forming a network can decrease emergency department and hospital admissions. Additionally, 38% said having a network can improve quality outcomes, and 29% cited appropriate decreases in length of stay as a top benefit.
In Detroit, the summit attendees largely confirmed these findings. One Director of Hospital Case Management said that their organization discovered that nearly half of their readmissions were coming from SNFs, as opposed to patients discharged to home or other locations. When they explored the data, they found that more SNF patients were readmitted over the weekend, when staffing levels are lower. Because of that trend, they now work with local facilities to make sure physicians do patient rounds on Fridays to reduce the risk of an acute event over the weekend.
Other attendees commented on the importance of educating patients and families on the care that can be provided at the skilled nursing facility. Facilities often relay that a patient’s family insisted the patient be taken back to the hospital, even in situations where it was not medically necessary. Setting better expectations with families throughout the care transition from hospital to SNF may prevent readmissions that are due to family anxiety.
The topic of forming preferred provider networks rounded out the morning. As the movement from volume to value continues to accelerate, it is important to keep in mind that SNFs are still highly dependent on volume for revenue. In order to make quality improvements that may also reduce revenue (such as shortening length of stay), facilities will want to know that their referrals will increase. Hospitals must continue providing patients with options, but designating a facility as a preferred provider can increase the likelihood that it will be selected. This kind of arrangement can benefit both the health system and the SNF by reducing the cost of an episode of care without decreasing SNF revenue.
Finally, while it is important to make decisions that support a health system’s bottom line, it is also important to do what is best for patient care. Developing a preferred provider network can achieve both goals. A preferred provider network creates opportunity for hospitals and skilled nursing facilities to work collaboratively on improving value-based metrics. It also means patients can be directed to a selection of high-quality providers to ensure they will receive the best care.
The summit was a great day that included a lot of lively discussion. Thanks to the presenters, panelists and attendees who joined us in Detroit. Next up: look for CarePort at ACE in Chicago on August 8!