Becker's Hospital Review

27 EXECUTIVE BRIEFING 2 EXECUTIVE BRIEFING SPONSORED BY Why patient data is the key to customizing the length of stay for post-acute care and reducing hospital readmissions A common misconception among payers and ACOs is that eliminating skilled nursing stays for post-acute patient care will save money. In reality, most patients who leave the acute care setting and find themselves in a skilled nursing facility (SNF) aren't stable enough to thrive in a home setting. A well-balanced, well-managed, appropriate length of stay is what these individuals need to ensure that they don't end up back in the hospital. Becker's Hospital Review recently spoke with Anthony Laflen, Senior Director, Acute and Payer Industry Market Leader at PointClickCare, about person-centered approaches to identifying the right SNF length of stay for patients. Based on his industry experience, he discussed the value of collaboration and information sharing across the care continuum. Access to patient information supports collaboration and reduces the likelihood of hospital readmissions Many payers, ACOs and facilities strive to minimize patient length of stay by focusing on "optimal utilization." According to Mr. Laflen, "This is often a one-size-fits-all approach. I'd prefer that organizations use live patient data to determine the right duration. Skilled nursing stays cost more than home health. However, randomly applying a length of stay metric and predetermining the patient's exit date from skilled nursing often results in hospital readmission spikes." Although hospitals and ambulatory practices historically have had little to no interaction with patients in the SNF setting due to time and resource constraints, most health plans have dedicated resources for managing members who are admitted to a skilled nursing facility. Mr. Laflen used to work for a company that operates skilled nursing facilities in the Pacific Northwest. He said most patients in this region use insurance products other than Medicare to cover SNF stays. "The variation in guidance and payer compliance requirements creates considerable complexity for providers," he explained. "Health plan nurses want information. Payers often need forms to be filled out and faxed. Meanwhile, providers may have to call the payer to advocate for a few more days of stay for a member. All of this slows the process down." A better alternative is to share the skilled nursing facilities' EHR information directly with health plans. "This enables collaboration and eliminates 'guesstimations' about the appropriate length of stay," Mr. Laflen said. "It supports a person-centered view of whether patients are truly ready to thrive in the next phase of their healthcare journey." Clinical data access also enables health systems to guide patients across the care continuum Traditionally, hospitals and ACOs haven't had access to live clinical data for patients in a SNF setting. This is changing, however. "When I look at how PointClickCare is opening our platform and sharing data, I'm excited to replicate that model with hospitals and ACOs," Mr. Laflen said. "We are slowly seeing a shift where open and transparent communication of information is beginning to inform upstream medical providers about how to intervene, collaborate and guide patients from one care setting to the next." Engagement between hospital systems, health plans and post-acute providers is becoming more common. "I love the willingness of providers to share information and ensure that they have a position in a local preferred network," Mr. Laflen said. "We're seeing the industry move toward true collaboration, where parties come together to evaluate patient stability using the most recent, accurate data. Length of stays are becoming more plausible and readmissions are definitely starting to drop." Health plans recognize that going at risk with forward- thinking post-acute care providers can reduce costs Since the most expensive patients for payers are those in skilled nursing facilities, finding post-acute care providers that are willing to be open, transparent and collaborative is valuable. These SNFs understand the key drivers related to payer and patient goals and they are willing to put their reputations and pocketbooks on the line. "Health plans must recognize that SNF operators aren't all the same," Mr. Laflen said. "Many are forward-thinking and willing to take on risk by putting readmissions or length of stay stipulations into contract language, provided that they receive more patients than in the past. As a payer, I would immediately latch onto an operator like that and contract with them. I'd even pay a higher rate, so the operator is rewarded for its extra efforts and for setting a market standard." Conclusion When it comes to patients receiving post-acute care, access to data is the key to better outcomes and lower costs. As the largest care collaboration network in the United States, PointClickCare is uniquely positioned to help payers, health systems and skilled nursing facilities share information. "We can give you the depth of data needed to intervene with patients in the post-acute setting, while providing insights, updates and traffic patterns related to where patients are right now," Mr. Laflen said. PointClickCare is a leading healthcare technology platform enabling meaningful collaboration and access to real-time insights at any stage of a patient's healthcare journey. Over 27,000 long-term post-acute care providers, and 2,700 hospitals use PointClickCare today. To learn more, visit PointClickCare.com

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