One of the goals of the 2010 Affordable Care Act is to improve the quality of care given to Medicare beneficiaries by providing Accountable Care Organizations (ACOs) — groups of hospitals, doctors, and other healthcare providers — with incentives for providing a better patient experience, minimizing unnecessary hospital admissions and readmissions, and potentially controlling costs. Increasingly, senior living partners are playing a key role in achieving these value-based care objectives.
In order for ACOs to their trust in senior care partners, the post-acute care provider must demonstrate that they can deliver effective transition coordination and quality care. They must also see evidence that the senior care provider uses timely interventions to keep patients from cycling back and forth between acute and senior care settings.
Of course the skill and experience of the partner’s care team is a factor in providing that reassurance. However, with the advances in senior care technology — everything from medication adherence monitoring to fall detection and predictive analytics — the solutions implemented by a senior living organization also help an ACO feel comfortable in a partnership. They want to know that a senior living organization is capable of achieving their quality and cost containment goals related to this demographic that requires the highest-cost services.
And the statistics support the value of having advanced technology in place. One case study shared by LeadingAge showed that an organization called Evangelical Homes of Michigan that uses Philips Lifeline products as well as offerings from other companies is delivering results that are exceeding their ACO partner’s high standards, with hospital readmissions in the 30 days post discharge ranging between just 3% and 6% compared to a national norm of about 20%.
The Importance of Processes and Technology
Senior living partners should have, and continually fine-tune, capabilities and initiatives for keeping seniors out of the hospital, one of an ACO’s major objectives. They should also invest in the processes that streamline communications, especially in the crucial hand-offs between hospitals and post-acute care. The processes could be as simple as check-lists and rely on “nurse-to-nurse and doctor-to-doctor” communication, that focus on monitoring patients 60 - 90 days after discharge. These processes should assist in coordinating and easing the transition of patients from one setting to another, as miscommunication between caregivers can be dangerous for any population and that is especially so for seniors.
Senior living partners should also investigate technologies that can interface with hospital databases, such as EMR (electronic medical records) or EHR (electronic health records). And finally, ACOs are required to report on outcomes, so partners should be able to demonstrate skill and experience in collecting, tracking, and reporting data.
To help cement a partnership with an ACO, aging-services providers should also take the four steps below, as suggested in a Senior Housing News article:
- Assess assisted living facility capabilities and alignment with hospital goals
Hospitals and physician groups face penalties if readmission rates are too high. Consequently they are looking for partners that can help them keep those rates down. Senior living providers should assess, and if necessary improve, their capabilities for keeping residents out of the hospital. - Establish care coordination programs
Senior living partners should invest both time and capital in processes that streamline communication, especially in the crucial handoffs between hospitals and post-acute care. Having senior care solutions that can integrate with hospital EMR or EHR systems is especially helpful. - Build coalitions of quality post-acute and long-term care providers
In today’s rapidly changing healthcare environment, collaborating with other post-acute care providers is essential. Consequently, senior living partners should be prepared to show ACOs that they are connected to others in their local community including therapists, counselors, and other ancillary services. - Measure and maintain the partnerships
ACOs are required to report on outcomes, so partners should be able to demonstrate skill and experience in collecting, tracking, and reporting on data.
The Power of ACO/Senior Care Partnerships
An effective partnership between an ACO and a senior care provider is a true win-win-win situation. The ACO achieves its objectives of providing a better experience for patients while keeping hospital readmissions and costs down. The senior living community becomes a preferred care provider and enjoys higher occupancy rates and greater name recognition. And the seniors themselves benefit from more attentive and more effective care that allows them to remain in their preferred setting as independently as possible.
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