The Role of Post-Acute Care in New Care Delivery Models
This American Hospital Association (AHA) white paper discusses the role of post-acute care (PAC) in new care delivery models via presentation of both background information and select case studies. The authors note a consistent rise in PAC utilization over the past several years coupled with geographic disparity in PAC spending has prompted an increased focus toward evidence-based PAC processes. Factors influencing PAC placements – such as patient diagnosis and provider preferences; the redesign of care processes and tools; and bundled payments that include PAC services – are discussed.
Case studies include both PAC- and partner-led innovations:
RML Specialty Hospital: This Chicago-based hospital demonstrated value to ACOs by employing a three-prong approach that included specializing in the most chronically critically ill patients.
Christiana Care Health System: In an effort to reduce preventable CHF readmissions from skilled nursing facilities, Christiana Care implemented a virtual telemonitoring program and risk prediction model in partnership with these SNFs.
Brooks Rehabilitation: Brooks, the largest U.S. inpatient rehabilitation facility, began participating in the BPCI bundled payment demonstration and redesigned their care approach (including using nurse care navigators to support patient transitions).
Kindred Healthcare: Kindred adopted an integrated market strategy in key locations where they assessed the most potential impact (e.g., Cleveland, where they began participating in BPCI bundling and implemented a quality improvement program in conjunction with the Cleveland Clinic).
Outcomes, lessons learned, and next steps (AHA recommendations for policy change) are also discussed in detail.
American Hospital Association. The Role of Post-Acute Care in New Care Delivery Models. December 2015. http://www.aha.org/research/policy/2015.shtml