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Premier: Health System Leaders Must Better Leverage Post-Acute Care Providers

December 14, 2016
by Rajiv Leventhal
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While 85 percent of health system leaders are interested in creating or expanding partnerships with preferred and local post-acute care providers, 90 percent report they may experience challenges in creating these partnerships, according to a survey from Charlotte, N.C.-based Premier Inc.

The survey findings highlight both the impetus for health systems to enlist post-acute care partners, and the need for guidance as they navigate how to optimize these partnerships to ensure patients receive optimal care, according to Premier, which conducted the survey online in summer 2016, representative of 52 C-suite health system executives across the U.S. “With a direct link in post-acute care variation and overall health system performance under evolving payment models, it is imperative for providers to effectively coordinate care across the continuum—especially those engaged in alternative payment models, such as accountable care organizations (ACOs) or bundled payment programs,” Premier said in a press release announcement of the survey’s findings.

Traditionally, according to Premier’s officials, hospitals have had loose or informal referral relationships with post-acute care providers, and there have been limited standards to help clinicians determine the best settings for this type of care. Faced with limited oversight in the past, significant variation among post-acute providers exists in the quality and costs of care, and the characteristics unique to each community fosters an environment where care may be duplicative, unnecessary or misused.

One such study found top post-acute care performers had an average Medicare length-of-stay of less than 24 days, while lower tier performers reported more than 34 days—a quality differential that adds up to about $4,000 per admission. To succeed in alternative payment models, health systems will need to consistently rely on a network of post-acute care providers acting as an extension of them by collaborating on shared goals and metrics, Premier officials attested.

To this end, based on health systems in Premier’s Bundled Payment Collaborative, Premier has released a guide for health systems that discusses how to effectively use new tools, data, case studies and other resources to improve the post-acute network development process, and replicate and scale successful strategies.

“Determining how much or what type of post-acute care is appropriate has always been a challenge, given the lack of data on post-acute outcomes and costs,” Andy Edeburn, a population health advisor at Premier, said in a statement. “The acceleration in value-based arrangements demands increased integration across the continuum as health systems become more accountable for the performance of post-acute care providers. Improved data and evidence-based thinking are driving different approaches to post-acute provider engagement.”

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