Managing Episodic Length of Stay (ELOS) in skilled nursing facilities (SNFs) is an important strategy to reduce unnecessary costs and improve outcomes during a patient’s episode of care. It is well established that SNF length of stay varies widely between geographic regions and by payer type (fee for service vs. managed Medicare, for example). This variability is perpetuated by a lack of accessible, standardized information about expectations, performance, and outcomes. The SNF Episodic Length of Stay (ELOS) Guidelines seek to address this issue by offering clinical recommendations and data-driven targets for managing SNF length of stay at the bundle level.
HealthEdge And Remedy Partners Launch Bundled Payments Initiative
Offering Enables Health Plans, TPAs, Self-Funded Plans and State Medicaid Plans to Administer Episode of Care Benefit Plan Designs
BURLINGTON, Mass.--(BUSINESS WIRE)--HealthEdge®, provider of the only integrated financial, administrative and clinical platform for health insurers, and Remedy Partners, the nation’s leading bundled payment company, today announced a collaboration to deliver a transformational platform to the market, capable of administering an entirely new category of health insurance benefit plan based on episodes of care and bundled payments.
This innovative offering provides a turnkey opportunity for payers, large self-funded employers and third party administrators to underwrite, sell, and/or administer episodes of care-based commercial products. The platform may be offered as a part of a comprehensive business process outsourcing (BPO) package or as a standalone platform for customers to independently manage the administration of episode of care plans.
“Bundled payments and episodes of care are part of the new reality of value-based reimbursements today,” said Steve Krupa, CEO of HealthEdge. “They will become even more important in the future and we are pleased to partner with the leader in the field, Remedy Partners, on this innovative offering.”
Remedy in the NewsRemedy Partners continues to be a strong advocate for the BPCI program and using bundled payment models as a path to healthcare transformation.
HealthEdge And Remedy Partners Launch Bundled Payments Initiative
Business Wire | June 21, 2017
Skilled Nursing ‘Under Siege,’ Quarter of Beds to Disappear by 2022
Skilled Nursing News | June 11, 2017
Put Bundles in the Toolkit: Highlights from The Seventh National Bundled Payment Summit
Bundled payments are the missing element from many organizations' toolkit for driving quality and efficiency. That was the theme emerging from the discussions taking place at the 2017 National Bundled Payment Summit which took place in Washington D.C. on June 26-28th.
One of the most important changes spurred by the practice of value-based care is how physicians may adjust the way they practice. Much of the opportunity to improve value lies in removing needless spending during the period following a hospitalization. For patients, this means spending more time recovering at home and less time in facilities. So what do doctors need to do differently to enable a home recovery?
Hospital-based specialists, generalists (e.g., hospitalists), and surgeons participating in bundled payment programs have tremendous influence over the quality and costs of patient care inside the four walls of the hospital. While many interventions also have effects after discharge, others have more limited post-acute impact. All things being equal, physicians should focus their in-hospital efforts on practices that have a positive effect on patients after they leave the hospital. For example, holding goals of care conversations, early mobilization, prompt discontinuation of urinary and central venous catheters, and asking discharge planners "Why not home?" are but a few of many practices that may improve healthcare value during the post-acute period. In the linked article, I describe how practices that represent 'thinking outside the DRG', or outside the inpatient stay, may improve patient care during recovery from a hospitalization.
Industry publication Fierce Healthcare shared Dr. Win Whitcomb’s strategies for post-acute care in an article published on October 3, 2016 that recapped Dr. Whitcomb’s panel at the CAPG Colloquium 2016.
Dr. Win Whitcomb, Remedy Partners Chief Medical Officer, was featured on a panel at the CAPG Colloquium 2016 held from September 29 through 30 in Washington, DC. CAPG is the leading U.S. trade association for and the voice of accountable physician organizations.
Selecting the optimal next site of care (NSOC) after hospital discharge has emerged as a core skill for physicians in the era of value-based healthcare. The challenge is that few of us have received formal training in post acute care site selection. When I meet with physicians and discuss NSOC selection, they express a clear desire for guidance on discharge planning as they work with patients, caregivers and the healthcare team. Here is a framework to assist physicians in post acute care selection within the BPCI program.
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, Business Development, was a featured speaker at the 13th Annual HealthMEDX User Group in St Louis on April 12 - 14, 2016.
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)
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.