Becker's Hospital Review

Executive Briefing: Post-Acute Care Strategy Additionally, the model is unique because CHC will work with the host hospital to develop clinical platforms for the LTACH. For instance, CHC can help the acute-care partner decide when a patient would benefit from long-term acute care. "In our model, we align with the acute-care strategies. In a for-profit model, they are very independent and siloed in their approach," says Mr. Bootz. 65 regular basis. "Even when an acute-care hospital has an LTACH strategy, [leaders] should evaluate if the LTACH strategy is the right one," he says. The following are four signs that it may be time to change LTACH strategy or partner. LTACH quality of care. The quality of care provided by the LTACH partner should be up to the standard of care provided at Benefits of long-term care the host acute-care hospital. If it slips below that level, Mr. Bootz Though the legal limitations and restrictions placed on long-term urges the acute-care hospital to rethink the partnership. If the care acute care can be a bit difficult to navigate, there are several provided at the LTACH is sub-standard, that reflects poorly on the benefits that come along with having an host hospital. "Acute-care hospitals forLTACH. get that it's not isolated. The hospital"If an acute-care hospital within-a-hospital's reputation is really Increased revenue. The LTACH will tied to the acute-care hospital's reputagenerally lease space from the acutehas determined an LTACH tion," he says. care host hospital — space that was previously underperforming or unused. would meet its market and Willingness to change. A great "Usually, the space hasn't been producLTACH operating partner will be willing revenue for the host hospital," Ms. community's needs, it can be ing to grow and modify the partnership Boney says. Therefore, the host hospital and long-term acute-care strategy, a great investment for both can transform part of its hospital to revwhile other partners will push to stay enue-producing through money gained at status quo. "As the acute-care hosthe acute-care hospital's from the lease agreement. Additionally, pital's strategy changes, so should the LTACHs usually buy ancillary services, balance sheet and its patient LTACH's strategy," Mr. Bootz says. For such as lab services, CT and MRI capainstance, if an acute-care hospital is bilities or even housekeeping services, population's outcomes." moving toward providing more trauma from the host hospital, creating a new care, the LTACH should gear up to asrevenue stream. sist in that effort. Diminished DRG revenue loss. Most diagnosis-related groups Contract value. All contracts associated with the LTACH parthave an appropriate length of stay of about three to five days, ner should be at fair market value, such as service outsourcing according to Ms. Boney. Beyond that length of stay, hospitals recontracts and lease payments. If they're not, that should trigger a ceive no further reimbursement from payers until a patient reachcontract renegotiation, according to Mr. Bootz. es their outlier status. However, patients who benefit from a longterm acute-care stay are usually in the hospital for about 25 days. General LTACH knowledge. Good LTACH operator partners Therefore, having the ability to transition patients to the LTACH will have vast knowledge of the changing laws that govern longwill help hospitals reduce resources and the associated losses term acute care. Hendrick Health System partners with CHC for from those extended stays. LTACH consulting, which Mr. Bessent says has been invaluable. "They work with LTACHs across the country, they know the inImproved patient care and outcomes. Ultimately, having the dustry," he says. The laws governing LTACHs can be difficult to option to transition a patient to the appropriate level of care will navigate and are subject to change, so an LTACH partner with improve that patient's health. "It gives patients a chance to heal regulatory knowledge is especially important. before they move to the next level of care," Ms. Boney says. Further, being able to easily place patients in the right care setting Overall, if an acute-care hospital has determined an LTACH can decrease readmission rates. would meet its market and community's needs, it can be a great investment for both the acute-care hospital's balance sheet and Evaluating LTACH strategy its patient population's outcomes. Having a long-term acuteFor hospitals that already have a long-term acute-care strategy, care strategy can also help hospitals shift to accountable care Mr. Bootz says it is still important to evaluate that strategy on a with more ease. n Community Hospital Corporation owns, manages and consults with hospitals through three distinct organizations — CHC Hospitals, CHC Consulting and CHC ContinueCare, which share a common purpose of preserving and protecting community hospitals.

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