Last week, we held the first virtual installment of our Care Coordination Summit series, “COVID-19 in Detroit,” featuring speakers from Henry Ford Health System, Advantage Living Centers and Health Alliance Plan (HAP). During the 90-minute live case study, the hospital, post-acute provider and payer shared how they worked together – using the CarePort platform – to successfully coordinate patient care during the COVID-19 surge in Detroit. In case you missed it, here’s what we learned from the three stakeholders.
When the COVID-19 surge hit Detroit, Henry Ford saw its skilled nursing facility referral acceptance rate plummet – from 45% in February to just 18.6% in April. To alleviate some of the backup, Gloria Rey, Post-Acute Care Director, Department of Population Health, recognized that SNF providers needed to be able see patients’ COVID-19 status more easily. Working with CarePort, Henry Ford quickly implemented technology changes to improve patient care and streamline patient transitions from the acute to post-acute setting. These small but impactful measures included sharing a patient’s COVID-19 status on the first page of the patient referral to make it easier to find. Within CarePort Guide, Henry Ford could also view and sort SNFs based on their ability and willingness to accept COVID-19-positive patients – as well as their isolation bed availability – which improved SNF acceptance rates. Using CarePort Connect and CarePort Insight, Henry Ford could also follow up with SNFs to let them know of a COVID-19-positive patient test result post-hospital discharge. Sue Craft, Vice President, Inpatient Case Management and Post-Acute Care Services, said that without these changes, “I’m not sure how we would’ve been able to get through all of this and get the information out that needed to go out.”
Another challenge for hospitals like Henry Ford were prior authorization workflows that typically take place during the patient referral process. To help Henry Ford, Health Alliance Plan (HAP) immediately stopped all authorization requirements for SNF placement as soon as Michigan declared a state of emergency – automatically providing authorization for all COVID-19-related illnesses to help facilitate the necessary care for inpatient members. HAP also relaxed outpatient authorization requirements for anything related to COVID-19 to ensure patients were treated appropriately. Leveraging CarePort’s real-time notifications, as well as daily huddles and operational calls with Henry Ford, HAP could better understand the situation of other stakeholders and where – as a health plan – it could remove barriers to facilitate patient care across the continuum
Post-acute providers such as Advantage Living Centers had to react quickly and make changes on a daily basis. From the onset, there were endless unknowns, and without access to tests, SNFs did their best to keep patients and staff safe. SNFs also received ever-changing guidance from the CDC and the state, and saw an influx of referrals – the average 60 to 90 referrals per week skyrocketed to 400 referrals per week mid-COVID-19 surge. These unprecedented circumstances made the need for transparent and increased communication between hospitals and SNFs that much more apparent.
Throughout the spring surge, Henry Ford increased communication with its partners across the continuum through daily meetings, which proved incredibly useful in understanding what was going on within the community, and so that Henry Ford could best help SNFs with their most critical needs. In addition to daily meetings with SNFs and other partners, Henry Ford also facilitated weekly SNF corporate leadership meetings, where the health system’s SNF partners joined together and worked collaboratively to identify barriers to optimal patient care. The open communication removed barriers, according to Gloria Rey, “The competition was all of a sudden out of the air and everyone was working collaboratively to focus in on patient care and making sure that we were trying to provide the best care we could. These meetings really helped bring that community piece together.
Advantage Living Centers participated in the daily huddles to understand hospitals’ needs and challenges – including the number of available ICU beds and the number of COVID-19-positive cases per day at the hospital. In turn, Advantage Living Centers provided updates – such as PPE or staffing shortages, and also constantly updated their CarePort Guide profile to reflect their latest bed availability and whether they could accept COVID-19-positive patients. This saved hospital case managers time by avoiding sending referrals to every post-acute facility in the area; instead, they could filter facilities by bed availability and their acceptance criteria, reducing the number of rejected referrals.
Collaborate Across the Continuum and the Community
Not only did HAP help its acute partner, Henry Ford, but it also worked to improve patient access to care and conducted additional outreach to at-risk or COVID-19-positive members to ensure they were provided the required health services – whether meal delivery, virtual behavioral health visits or telehealth check-ins. HAP’s telehealth visits, originally averaging 1,000 per month, spiked to nearly 86,000 at the peak of COVID-19 – and to ensure streamlined transitions of care, HAP has made between 11,000 to 12,000 telephonic reach outs to its members since the COVID-19 outbreak began in Michigan.
With more than 15,000 COVID-19-positive cases in Detroit within the first month of the COVID-19 surge, hospitals such as Henry Ford initially lacked sufficient PPE to properly care for patients and keep staff safe. Following community donations, however, Henry Ford had secured so much PPE that they actually had a surplus. Post-acute providers like Advantage Living Centers had the opposite problem and lacked the PPE it needed to keep staff safe. To help its partners in a time of need, Henry Ford donated its surplus of supplies – 70,000 N-95 masks, 800,000 pairs of gloves and innumerable gowns and face shields – to its post-acute partners. Henry Ford and Advantage Living Centers are confident that this increased level of collaboration will continue beyond COVID-19. Although hospitals and post-acute providers may all be stakeholders in healthcare, they have different obstacles to overcome and it is crucial to remain transparent about those barriers to provide the best possible patient care.
Watch the full-length recording of the live case study, and stay tuned for upcoming blog posts where we’ll further delve into the experiences of Henry Ford Health System, Advantage Living Centers and HAP during Detroit’s COVID-19 surge.