The Perfect is the Enemy of the Good
Before I started working for Remedy Partners as a Transitional Care Specialist assisting a Model 2 Acute Care Hospital Episode Initiator (EI) in identifying, engaging, and tracking BPCI patients during their episodes of care, one of the nurses preparing me for the job told me that “if you accomplish nothing else… get them to pick up the phone.” Her point was that if we are not able to speak to our patients after discharge then it will be difficult, if not impossible, to influence the outcome of that patient’s recovery. This was some of the best advice that I received but it assumed that we had already identified the patient as a BPCI patient.
Remedy Partners’ 2017 National Innovation Collaborative:
The Year’s Largest Gathering of Professionals Dedicated to Bundled Payments
Remedy Partners November 13, 2017
This year’s largest gathering of bundled payment operators will convene at Remedy Partners’ Fourth Annual National Innovation Collaborative in Atlanta, GA on November 16 -17. The conference, open to Remedy Partners’ clients and collaborators, is expected to garner more than 350 attendees. It will balance presentations from industry thought leaders with those of professionals working in bundled payment programs on a daily basis.
Remedy in the News
Bundled Payment Report Illustrates Increased Demand for Home Health
Home Health Care News | November 2, 2017
Remedy Partners names EVP of commercial business lines: 3 things to know
Becker's Hospital Review | November 1, 2017
Three reasons your SNF should sign up for CMS's BPCI Advanced Program
McKnight's Long-Term Care News | November 1, 2017
Remedy Partners Announces that One Hundred Percent of its Hospital Partners Achieve Positive Net Payment Reconciliation Amount (NPRA) in Bundled Payment Initiative
Medicare’s voluntary BPCI program’s financial results reveal positive NPRA for 100 percent of Remedy Partners’ engaged hospitals and 81 percent of its partner clients
The Perfect is the Enemy of the Good
Home health care has become an increasingly viable option for individuals seeking post acute care in their own homes, and the selection of home care as the next site of care when appropriate can contribute to success in a bundled payment program. Because there are nuances to the use of home health services in a bundled payment program, Remedy Partners convened two events to address the intersection of the BPCI program and home health services in Florida: the first-ever Home Health Town Hall and a BPCI & HH Symposium.
A key element of discharge planning - the selection of the next site of care - is more important and more complex than ever before, due in large part to the advent of the BPCI program and the episodic approach to care. Once the realm of laminated checklists, frayed brochures and quick conversations, hospitals are now finding technology to be a powerful tool to assist them in the selection of an appropriate next site of care.
Gene Huang, Remedy Partners Vice President of Business Development, was invited to speak on a panel at LTC 100, the premier leadership and strategy conference for C-level executives from large skilled nursing providers.
Win Whitcomb, MD, MHM, Remedy’s Chief Medical Officer was invited to speak at the American College of Physicians (ACP) Annual Meeting, the nation’s largest annual gathering of internal medicine doctors, including a dedicated track for hospitalists. More than 6,000 internal medicine physicians, subspecialists, medical students, and allied health professionals from around the world are attending the ACP Internal Medicine Meeting 2016, held this year in Washington, D.C. from May 5 - 7.
Bundled payment programs require effective care coordination encompassing the hospitalization and the post-discharge recovery period. Within this care coordination process, selecting the ‘next site of care’ after hospital discharge is a crucial element in the provision of high value patient care. Why? When looking at large data sets representing aggregate spending, the cost of post-acute care can rival that of the initial inpatient stay.(1) For many bundles, total 90-day episode spending for a patient discharged to a skilled nursing facility can be more than two times that of a patient discharged to home.(2)
Why CMS is Focusing on Post Acute Care
Healthcare is increasingly transitioning to value based payment models in an effort to control spending and improve quality. In 2014, the amount spent on healthcare in the U.S. per individual reached $9,523—more than twice the average of all other developed countries—and is projected to reach $14,103 by 2021 if unchecked. Total healthcare spending represents almost 18% of GDP, and is expected to grow to 20% in the next five years. Furthermore, Medicare alone represented 20% of National Healthcare Expenditures
in 2013, and is expected to increase significantly after 2015 due to growing utilization of medications and services by an aging population.
Implementing a bundled payment program requires new knowledge, sophistication and skill. In my healthcare career of 40 years focused on managed care and the hospitalist specialty, my work with Remedy and bundled payments again has me facing a steep learning curve. Here I list my Top Ten "Aha!" learnings at Remedy, in no particular order.
From ‘Who We Are’ on RemedyPartners.com Our Core Value: Empathy
SNF Readmission and Mortality Risk Versus Discharges to Home
Co-Authored by Steve Wiggins, Brittain Brantley, Mary Dittrich, MD, Marina Burke, NP, Win Whitcomb, MD
Evidence is growing that patients fare comparatively well when choosing to go home after a hospitalization, versus being admitted to a post acute facility. Patients discharged to
their homes have readmission and mortality risk that is equivalent and possibly lower than patients with similar conditions who are discharged to skilled nursing facilities (SNFs) or other post acute facilities. Remedy’s own research, as well as studies published by the American Heart Association and the American Journal of Medicine, provides encouraging evidence to support discharges to home for challenging patients.