To win the continuum-of-care relay race, it's crucial to know when to hand off the baton.
That's one of the secrets to operating under the new Medicare post-acute reimbursement system, says healthcare consultant Cherilyn Murer.
By handing off patients to the next level of care at the most appropriate time, hospital systems can make the most of their reimbursements and provide better care for their patients, she says.
Murer's presentation at the annual congress of the ACHE is titled "The Future of Post Acute Care: Strategies for Responding to the Balanced Budget Act" and is intended to help hospital systems meet the financial, regulatory, marketing and operational challenges of the new payment system. The session is set for 10 a.m. and 2 p.m. Monday, March 8.
By changing the Medicare payment system for home healthcare, skilled-nursing and outpatient procedures from cost-based reimbursement to a fixed daily rate, Congress "took our health delivery system and turned it 180 degrees," Murer says.
Since 1983, hospital systems had an incentive to minimize costs on acute care and maximize them on post-acute care. Under the new payment system, they will need to contain costs across the continuum of care.
The payment reforms have left many hospital systems complaining that they'll have fewer dollars to provide the same amount of care.
But Murer doesn't buy the doom-and-gloom outlook.
"There's so much money available and so many resources. We just need to know how to access them," she says.
In her session, Murer will suggest "critical strategies" for hospitals embarking on the post-acute prospective payment system by presenting a series of case studies.
The key, she says, is to make the handoff from one type of care to the next as seamless as possible. Rather than look only at the kinds of care directly affected by the new reimbursement systems, hospitals would do better to look at costs across the care spectrum.
Some hospital systems may determine that owning the full continuum of care themselves is neither feasible nor desirable. Instead, they'll forge links with outside partners, including developers and rural hospitals.
Above all, Murer says, hospitals must take off their blinders and look at the post-acute payment changes from the viewpoint of the entire system of care.
By coordinating a patient's movement through the continuum, hospitals can pool resources from what they might otherwise view as separate, stand-alone types of care.
"If you look at it from a (single point of care) perspective, you will see this as a negative period of time," she says. "But if you look at the spectrum of care, the future is very bright."