When St. Luke's University Health Network assumed a new level of financial risk for 84 services under Medicare's voluntary bundled-payment program, the system's leaders knew they needed to whittle down the list of preferred post-acute providers to improve outcomes and reduce costs.
By analyzing data and working with skilled-nursing facilities to improve their processes, the seven-hospital system based in Bethlehem, Pa., drastically cut the number of days its patients spent in the facilities, as well as how frequently they needed to be hospitalized again when they left.
“Data analysis was really key to our success, and having data on the performance of post-acute providers was extremely eye-opening,” said Donna Sabol, St. Luke's chief quality officer. “It was very evident that patients who were in managed-care products had half the length of stay in (skilled-nursing facilities) compared to those that were Medicare fee-for-service,” she said. Medicare fee-for-service plans have broad networks, while managed-care plans typically direct patients to specific providers.
To create a high-performing post-acute care network, St. Luke's turned to the providers with whom it already had a strong relationship. It then collected performance data from nursing facilities to promote competition, informing them that they could be removed from the preferred list if they don't perform well enough. The system also went a few steps further to train, educate and build care protocols and transition-of-care processes for those providers. It even embedded its own physicians in the nursing facilities to better teach them protocols and held quarterly meetings with their administrative teams to talk progress.