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Whether it is through contracted services, formal and informational discussions, or joint operating committees, post-acute providers are finding different ways to offer their services to the quickly expanding roster of accountable care organizations.
And while the transition toward integrated care--and a new payment model that rewards for it--has everyone re-thinking how they deliver care, many post-acute providers say their work with ACOs is a natural progression for their businesses.
"There is an increasing recognition that today about 35% to 40% of Medicare beneficiaries who are leaving a hospital need some form of post-acute care," says William Altman, executive vice president of strategy and integrated care at Louisville, Ky.-based Kindred Healthcare, a large operator of post-acute services, including long-term care, skilled nursing, assisted living, rehabilitation, home care and hospice.
"Today, those patients use post-acute care without a great deal of coordination. So those patients are using multiple sites of post-acute care," he says, adding that this often leads to problems of readmission. "We have found in the last year or so there is a high level of interest from hospitals, health systems and managed-care payers in working with post-acute providers on how to better manage that post-acute episode."
Kathleen Griffin, national director of post-acute and senior services at consulting firm Health Dimensions Group, says the most important gap for an ACO to manage cost, quality and outcomes on a post-acute basis is at skilled-nursing facilities, the venue where the largest volume of post-acute patients stay. As she explains, the majority of health systems interested in an ACO are forming continuing-care networks.
"I think that the type of relationship is less important than a clinically integrated partnership," Griffin says. "How you structure the relationship--affiliation agreement, as a full-fledged partner, or contracted arrangement--the most important thing is that you've done the work on both sides to create a seamless, clinically integrated delivery system for the patients."
There is nothing that precludes a post-acute company from acting as a...