Hospitals traditionally have viewed a patient’s discharge as the endpoint of their care responsibilities. Little attention was paid to the next steps in treatment once the patient left the building. In reality, hospital stays frequently are just one step in ongoing care. Ensuring a smooth transition from acute to post-acute and long-term care settings is critical to achieving optimal health and prevent unnecessary hospital readmissions.
The number of people 65 and older is increasing significantly and both insurance and acute care providers are taking notice of the critical role long-term care services play in ensuring the continuity and quality of care. Long-term care communities like South Coast Post Acute are key to addressing the complexities of patients who are elderly, chronically ill or struggling with behavioral health issues.
What’s Driving the Change in Post-Acute Care?
1. A dramatically changing population
More than two-thirds of 65-year-olds will need assistance to deal with impaired functioning during their remaining years. Adding to the soaring demand for services is the growth in younger patients with chronic and disabling conditions. To be prepared, post-acute providers have developed:
- New treatment models that address chronic disease management, as well as integrated or coordinated care at the provider level across physical health, behavioral health and social support needs, including access to affordable housing.
- New training curricula to ensure all providers and care managers are trained in emerging care coordination and management models that support patients with chronic conditions.
2. Increased payer and policymaker attention on spending, quality and outcomes.
Medicare and Medicaid are focused on reducing hospital readmissions. Overall, we have significant opportunities to improve care and limit costs for populations with chronic conditions. Forces driving change include:
- A shift to value-based payments and a commitment to population-health management to improve quality and control costs.
- Increased managed care arrangements for elderly and disabled populations. To stay in network, post-acute providers must demonstrate quality and cost effectiveness.
- A focus on standardized health and functional assessments to ensure patients are placed in the lowest-cost facility that meets their needs.
- A rise in quality measurement and reporting. Post-acute care providers developed metrics to assess their results and implement needed improvements.
3. The integration of large health systems with post-acute care providers.
Facing financial penalties for readmissions, health systems are increasingly looking to partner with post-acute care providers. Three-quarters of hospitals subject to Medicare’s Hospital Readmissions Reduction Program are being penalized for 30-day hospital readmissions — with Medicare estimating fines totaling $428 million over the year. That amount of money is a strong motivator for hospitals and health systems to find ways of partnering with post-acute care providers to lower readmission rates.
Acute and post-acute care providers have always informally worked together. Now they are joining forces to ensure seamless care transitions, enhance quality and improve outcomes, while protecting their own financial futures.
In this new environment, acute care providers know the importance of post-acute care providers in supporting patients post discharge and lowering readmission rates. South Coast Post Acute has one of the lowest re-hospitalization rates in Southern California.