Integrated Networks Trigger Rise in Post-Acute Care Accountability

Thursday, June 25th, 2015
This post was written by Patricia Donovan

Healthcare is examining new post-acute care (PAC) delivery and reimbursement models.

As physician-hospital associations (PHOs) and clinically integrated networks increasingly monitor referrals and where patients go once they leave the office or hospital setting, the post-acute care market will be held more accountable for the quality and cost of care they provide and their ability to manage readmissions, predicts Travis Ansel, senior manager with the Healthcare Strategy Group. Here, Ansel suggests how PHOs might prepare for the eventual inclusion of post-acute care in their networks.

Healthcare Strategy Group did a lot of work in Arkansas in 2011 and 2012. As providers started being held accountable for what happened once their patients left the hospital, post-acute care became very relevant in the Arkansas market. This was due to the impact on the providers, and on the physicians of the hospitals in that market. Almost immediately upon the announcement of the models, the hospital started bringing in different post-acute care organizations, saying, These are our incentives. We’re trying to manage patients who have been assigned these diagnosis-related groups (DRGs). We’re trying to manage these factors for those patients. Either you’re going to be the one to help us to do it, or we’ve going to find someone else in the market to do it.

My general expectation would be that as hospitals and physicians get together and start talking more about how post-acute care affects them, we’ll see them bringing in post-acute care to have that discussion: either help us with what we’re being held accountable for, or we will find someone else who can.

The natural market reaction to that is post-acute care organizations will either compete to respond to those requirements, because there will be some opportunity to grow market share or grow reimbursement if they’re effective in responding to those things.

We’ve already seen a tremendous amount of consolidation in the post-acute care world over the last five to ten years. To me, that would signal a lot more consolidation, the same as we’ve seen with the provider market. They’re going to look for a capital infusion and build competencies that will help them respond to PHOs’ requests.

Note: Have more thoughts on the rise of accountability for post-acute care? Answer 10 Questions on Post-Acute Care Trends.

Source: Physician-Hospital Organizations: Framework for Clinical Integration and Value-Based Reimbursement

Travis Ansel, MBA, is a Manager, Strategic Services with Healthcare Strategy Group, LLC, with a primary focus on hospital strategic planning, physician alignment planning and clinical integration.

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