A new approach
Scott Santucci, a former colleague of mine, recently started “The Sales Enablement Society” on LinkedIn. It exists for professionals to collaborate and brainstorm all things sales enablement. In less than nine months, this group has grown to include international chapters in Australia, UK, Europe and the list keeps growing. Why am I telling you this? Because it epitomizes positive change. It’s an example of a vision coming alive and gaining momentum, turning new ideas into reality. Stuff that makes life so damn much fun.
When like-minded professionals share their passion and collaborate, extraordinary change can happen. Now is the time for those in the post-acute care industry to do just that.
On September 28, 2016, Centers for Medicare and Medicaid Services (CMS) published a “Final Rule,” titled “Improvement for care, safety, and consumer protections for long-term care facility residents.” The goals set therein impact millions of residents in thousands of long-term care facilities, so the scope is significant. And meeting these goals brings new challenges to the fore that require changes to how we think about post-acute care, how we do business, and how we measure success.
So, how will post-acute care providers respond?
I have been the vice-president of operations, support services, procurement/contracts, and I’ve been on the senior management team of one of the most progressive skilled and transitional care operators in the United States. So I’ve lived in this space for many years, and one thing is crystal clear for those of us in the post-acute care industry. We need to embrace change.
Meeting the goals and standards in the CMS Final Rule requires us to clearly identify the level of care each long-term care facility is capable of providing, profitably. Furthermore, we need to understand our cost at the point of care, preadmission and upon any change of condition. So as professionals in the post-acute care industry, we need to collaborate with each other and with our partners to figure out how we can rise to these new challenges.
“So I’ve lived in this space for many years, and one thing is crystal clear for those of us in the post-acute care industry. We need to embrace change.”
As we transition from fee-for-service to value-based purchasing, bundled payments, and shared risk, our first and primary objective should be to demonstrate the true value each of our facilities provides to the residents and patients it serves. It is only then, by verifying our acute care capabilities to referring and payer partners, that post-acute care providers will positively affect hospital readmissions and the total cost of care, tenets of the CMS Final Rule.
Here’s another reality. For some PAC providers, the average length of stay is less than 21 days for a significant portion of their residents. At that point, they are no longer “long-term care” facilities, but are now transitional med/surge units providing acute care, and they must operate differently from a long-term care facility. My point is that each provider must identify their own capabilities across their entire facility, not only to comply with the CMS Final Rule, but also to articulate it to referring and paying partners. If we are going to reduce unnecessary hospital readmissions and improve care quality as required by the CMS Final Rule, hospitals have to clearly understand which providers are best suited to provide the care required for each patient.
To help facilitate positive change, I and a few of those colleagues I alluded to earlier, along with some brilliant technology entrepreneurs, began to collaborate. We eventually started a company, called Acute2020TM, Inc., to continue that collaboration and provide innovative solutions that allow PAC providers, referring hospitals, MCOs and ACOs to embrace the challenges presented by change.