Post-Acute Care Strategy
LBMC’s Post-Acute Care Consulting Team of experts assist with the coordination of care among ambulatory, acute and post-acute care (PAC) providers from an operational perspective. LBMC’s team provides services to post-acute care providers to help them effectively respond to strategic, regulatory and reimbursement challenges. We also partner with hospitals to develop post-acute care network strategies and focus on more coordinated less-costly continuum of care.
The New World of Growing Post-Acute Care Networks
Acute care hospitals are working to find new ways to collaborate with post-acute care providers. Driven by the increasing prevalence of ACOs, episode-based reimbursement models, and hospital readmission penalties, these relationships are vital. In this guide, we’ll explore the new operational demands and offer insights and solutions on how to address them.
The LBMC Difference
The LBMC team of experts has served in various C-suite healthcare leadership roles. This expertise enables our LBMC experts to understand the major operational challenges of all healthcare post-acute providers, bringing practical expertise to improve operational performance and boost the bottom-line.
- As reimbursement challenges continue to rise amid the increasing financial constraints imposed by recurring cuts to Medicare and Medicaid, providers must develop new fiscally strong strategies to preserve and increase revenue. Regardless of the downward pressure on revenue, the patients need and must receive high quality care.
- Coordination of care among ambulatory, acute and post-acute care providers is critical. Effective strategies begin with managing care prior to an acute episode and collaborating with all providers and the patient throughout the continuum to ensure safe transition back into the community.
- LBMC’s Care Continuum Coordination model provides the framework for physicians, acute care hospitals and post-acute care providers to achieve the highest quality patient care.
Who could benefit from a post-acute care strategy opportunity?
- Medical care providers, including physicians and non-physician providers
- Post-acute care providers, including long-term hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs) and home health agencies
Advantages to working with LBMC on post-acute care strategy
- Better management of patients throughout the healthcare continuum
- Controlling costs under bundled payment and value-based payment models
- Improving patient quality
- Additional revenue streams
- Increased reimbursement
Developing a Post Acute Care Strategy
Many hospitals are turning to outside organizations to guide them in the development and management of their post-acute care (PAC) strategy. With the increasing penalties tied to readmissions, the growing prevalence of accountable care organizations (ACOs) and the advancement of bundled payment programs, hospitals are expected to provide care and guidance to their patients for 30 to 90 days after discharge. Whether the need is to better manage bundled payment models or address escalating readmission penalties, most hospitals lack the internal expertise and/or technology necessary to effectively manage these strategies.
If there are no internal resources available, many hospitals turn to professional service firms and technology companies that provide post-acute care network support services. The solutions range from providing software only to full PAC network management, which includes software, data analytics, reorganization of hospital processes, PAC provider network development and management, care redesign services, and clinical transitional care support.
Hospitals seeking outside resources often opt for the minimum support to save money. However, they may be paying a lot more down the road if they choose a solution based solely on cost. The less provided by an outside organization, the more hospital resources must be used. Many times, the lowest cost solution does not provide the best value.
In one instance, a hospital selection committee expressed to potential outside partners, that they were looking for a solution to purchase and run themselves. While this sounds like a solid approach to minimize spend, it underestimates the hospital staff time and resources required to effectively use the solution. Very few hospitals, if any, have idle staff who can operate the software and apply the necessary decision support. The cost of training hospital staff to implement the solution must also be considered, as well as the potential for the turnover of skilled staff and the training of new staff.
A hospital CFO recently recounted his experience using a “technical only” solution. The software helped the hospital decide what PAC provider would provide the best expected patient outcomes. However, the CFO stated that the process required significant hospital staff time to download data from CMS, enter it into the software, interpret the data, apply clinical insight to the data, provide operational input into the PAC provider selection (from only the acute-care perspective), provide clinical transitional care support to guide the patient through the care continuum, and receive and interpret the outcomes from the overall patient encounter. The solution required more than just hitting a button.
Another hospital executive stated that while the technology solution they used was effective at providing data analytics and informative dashboards, it did nothing to guide them operationally. “It provided us with great information, and we could see all of the levers, but we did not know which levers to pull,” he said. It was like operating without a manual. What good is a system if you don’t know how to use it?
Hospitals are entering a new era of care continuum management. They cannot be expected to navigate PAC with software alone. A full PAC network management partner might yield the best outcomes for hospital patients and might end up costing less in the long run.
Physician Post-Acute Care Consulting Services
- Identifying Physician Opportunities in Post- Acute Care
- Coding and Billing Education
- Utilization of Non-Physician Providers
- Compliance Program Development and Implementation
- Revenue Cycle Management
- HIPAA Privacy and Security Audits
- Practice and Billing Assessments
- Provider Enrollment and Credentialing
- Practice Management Consulting
- Electronic Medical Record Vendor Review, Selection, and Implementation
Hospital Post-Acute Care Consulting Services
- Post-Acute Care Strategy Development
- Bundled Payment Program Evaluation
- Post-Acute Care Partner Evaluation
- Discharge Planning Analysis
- CJR Collaborator Agreement Review
- Episode-Based Post-Acute Care Contracts
- Cost Report Review and Preparation
- Co-management and JV Arrangement Development
- Income Guarantee Monthly Computation Services
- Community Health and Physician Needs Assessments
Post-Acute Care Provider Consulting Services
- Value-Based Purchasing Strategy Development
- Final Rule and IMPACT Act Compliance
- SNFist Program Implementation
- Antibiotic Stewardship Program Development
- Hospital Readmission Protocol Implementation
- Quality Measures and 5 Star Rating Improvement
- Revenue Cycle Management
- Cost Report Review and Preparation
- Creation of Community Specific Care Management Programs
- HIPAA Compliance/HIM/IT Security
- LTPAC Software Selection, Implementation and Management