Implementing a value based health care delivery model
value based health care delivery model in post acute care
Medicare’s fee for service payment for post-acute care amounted to $60 billion in 2015 (Med PAC). Utilization pattern in post-acute is largely dictated by geographical variations. Nearly 22.3% of all patients discharged from acute care hospitals require post-acute care (AHRQ). The post-acute industry is fragmented and boundaries of the industry span all services offered to patients post discharge from the hospital by non-acute care hospital providers.
Only 7% of the hospitals believed that there is coordination between them and the post-acute organizations serving their patients (NJEM, 2016). As acute care hospitals have made the transition towards value based care; there has been almost no movement in post-acute industry to increase value. The industry remains largely fragmented and consists of thousands of smaller providers with very little coordination.
My objective is to transform the post-acute services delivered by our organization and implement value based healthcare by integrating, improving outcome and reducing cost. There are several challenges, biggest of which is our small size which present a barrier on focusing on relatively narrow set of conditions. Our small size also challenges in our ability to invest in IT infrastructure. The small size also is an asset for us as we undertake this journey since we can make required decisions quickly and allocate resources where needed.
Agree with you Amit, smaller organisations do have the flexibility to move quicker but do have limited resources- in my experience partnering with other like minded organisations helps overcome challenges.
Our system has prioritized communication and coordination with each patient’s Primary Care Provider to leverage that relationship to the patient. It has cut down on readmission rates quite a bit. We have case managers in the hospital that know the local resources for post acute care well. We have cultivated relationships with facilities that provide good quality care and steered clear of those with lesser quality. Lack of IT infrastructure may be problematic, but may not be if there are multiple platforms being used in the area, as they often don’t speak well to each other anyway. A fax machine is probably more reliable.