The Remedy Partners Way: Networks, People, and Episode Tools Help Patients Recover at Home, Avoid Rehospitalization
Since mid-2014, when Remedy Partners’ post-acute care redesign efforts began to be broadly scaled, we have seen a substantial decrease in skilled nursing facility (SNF) length of stay with no increase in readmissions for patients who initially go to a SNF before returning home after hospitalization. We can attribute these results in large part to a multi-pronged approach consisting of post-acute network representatives working with SNFs on performance improvement, the creation of SNF performance networks1 and the widespread adoption of the tools in Remedy Partners’ SNF Episodic Length of Stay Guide.2 We also recognize the remarkable effort our episode initiator hospitals and physician groups have put forth working with SNFs to optimize efficiency and quality. Figure 1 shows initial SNF length of stay from Q3 2014 through Q1 2017, with a decrease from 30 to 24.2 days, or a 21% relative reduction.*
In order to assess whether shorter stays in the SNF resulted in more readmissions, we looked at readmission rates for the time period proximate to SNF discharge, specifically 7 days and 15 days (Figure 2) post SNF discharge. Figure 2 shows 7-day readmission rates essentially unchanged in the 4.6% to 4.9% range and 15-day readmission rates also stable in the 10.0% to 10.1% range.
What are the major factors associated with lower SNF length of stay with no adverse effect on readmissions?
Post Acute Network Representatives
Remedy Partners deploys PAN representatives in dozens of US markets to work with SNFs to efficiently guide patients through their stay and transition safely to home.
SNF Performance Networks1
Remedy Partners’ methodology for inclusion in a performance network employs utilization data, star ratings, selected outcomes, clinical programs and capabilities, and local factors such as affiliations.
Episodic Length of Stay Guide2
The ELOS guide, substantially improved in early 2017, provides benchmark SNF length of stay data for the 48 BPCI bundles and a detailed process map for nursing, rehabilitation and social work on admission, during the stay, and on discharge as they guide patients to a successful transition home.
As part of a multi-pronged approach described here, our episode initiator hospitals and physician groups have enabled patients in aggregate to spend more than 400,000 more nights recovering in their own beds than if no length of stay improvements were made. In a forthcoming blog post, we will look at the impact of the use of a performance network on outcomes and cost.
*Data reflects Remedy Partners’ entire Model 2 program. Performance for each quarter over the time period was standardized according to bundles selected for Q3 2017.1. http://blog.remedypartners.com/narrow-snf-networks-and-increased-collaboration-the-remedy-approach