Hospital executives are facing a relatively new challenge: managing the financial risk of bundled or capitated payment after a patient is discharged. Now that post–acute care providers are an extension of a hospital’s care delivery model their performance has direct implications for the hospital’s bottom line. Not only must these providers meet threshold cost, quality and patient satisfaction expectations, they must also agree to performance targets and service level standards as well as forge a relationship where transparency, accountability and continuous improvement are the norm. Managing the financial risk is not easy but hospital executives are seeking new ways to manage these relationships and achieve optimal financial and quality outcomes.
Best Practices
A collaborative relationship between a hospital and a post–acute care provider requires a greater level of trust, cooperation and mutual accountability than has been typical. So, what best practices can hospitals look at to establish these relationships most efficiently?
Strong external partnerships start with a strong internal partnership
All too often, executives make important decisions about partnership objectives without the right people at the table. Because post-acute partnerships balance clinical, operational and financial needs, key stakeholders should include discharging physicians and care management professionals. Stakeholders need to agree on the services and performance commitments and expect partners to help manage the relationship.
Strong partnerships require shared values
Strong quality performance metrics, a strong safety record and sound staffing ratios are all critical aspects of provider performance, but shared values and a common commitment are important. Common culture, mission and patient care philosophies are the core of strong partnerships.
Results from strong partnerships
Hospital executives preparing to assume greater risk understand that better partnerships with high-performing post–acute care partners are essential. Organizations that have already embraced this concept have seen dramatic decreases in length of stay, hospital readmissions and variation in post–acute care delivery costs and quality. These improvements have translated into reduced readmission payment penalties, increased shared savings payments, improved outcomes and greater patient satisfaction scores.
As the shift to value-based payment models continues, hospitals will be well-served by establishing high-performing, value-focused relationships with their post-acute partners.