How One Large Hospital Delivered Better Care with a Multi-Provider Network

Healthcare providers and payers are moving beyond the technical integration of healthcare reform and into a new phase of developing the organizational dynamics needed to launch lasting initiatives and new models of care. This evolution requires close attention to the mechanics of partnership development across the healthcare continuum and an examination of how attitudes, behaviors, and perceptions play a role. Investing in relationships can help illuminate what each entity needs from the others to transform an agreement into a productive partnership. For one academic hospital seeking progressive ways to streamline costs and deliver better care, it focused on collaboration and transformation.

The Highlights

• Our academic hospital client addressed an annual $12 million in avoidable costs by developing and implementing a multi-provider partnership initiative.
• Our project successfully implemented a community care network with 20 skilled nursing facilities and two home health agencies.
• We customized programs and policies to improve coordination and achieve desired outcomes, including improved efficiency of patient throughput within the hospital and an overall reduction in readmissions, emergency department utilization, and skilled nursing facility average length of stay.

The Opportunity

Like many healthcare organizations today, our client, a large academic hospital, recognized the importance of preparing for a value-based, accountable care environment and the need for new strategies to match. For this hospital, internal concerns regarding unnecessarily long lengths of stay and inefficient throughput, which were estimated to potentially cost over $12 million annually, were among the initial drivers for pursuing the opportunity to align their patients and services with high-performing post-acute care providers in their geographical area to develop a new care network.

As part of this project, the hospital also identified its responsibility as transcending into the post-acute environment to ensure that downstream providers maximize value by delivering efficient, high-quality care. This position arose from the reality that hospitals are increasingly required to take on significant financial risk concerning patient outcomes, even after they leave the facility. Mandatory programs currently place at least 6% of Medicare inpatient payments at risk. Though it may seem like a small percentage, this is equivalent to $16 million for a hospital.

The Approach

Our approach focused on developing customized programs to help the hospital adapt its systems to streamline costs while delivering better care. Our work required understanding the financial and operational aspects of network development and the ability to integrate perspectives from multiple provider types and stakeholders.

The hospital’s focus on ensuring quality of care throughout the downstream providers was the lens through which we created a robust RFP and on-site assessment process to create a new multi-provider care network. We believe that partnerships aren’t simply agreements on paper – they’re relationships that require collaboration and communication. This is why we also created opportunities to facilitate dialogue between the hospital’s leadership and post-acute providers during the RFP process and the final implementation launch.

Creating the network itself wouldn’t have been enough. Heading into the launch, we developed a process and metrics to track, monitor, and evaluate the network’s effectiveness. In addition, we helped place an employee experienced in post-acute care into a new full-time director position to oversee the network and continue facilitating communication among the multiple providers.

The Potential Realized

With a custom strategy and sustainable implementation plan, we enabled this hospital to meet its objective of developing and implementing a new multi-provider network with 20 skilled nursing facilities and two home health agencies joining the network. The client also saw immediate effectiveness from implementing customized programs and processes, including improved communication and coordination.

The first round of data analysis found that the PAC network successfully met initial targets in nearly all measurable metrics, including improved efficiency within the hospital by reducing door-to-bed time for admitted patients. Also, expectations were far surpassed for readmission reduction (11.8% for skilled nursing facilities and 5.7% for home health agencies), emergency department utilization (5.92%), and average length of stay for skilled nursing facilities (13.8 days).

Through purposeful partnership and a sustainable approach, there is potential to improve care delivery while streamlining costs. For this academic hospital, this is the best of both worlds.his is the best of both worlds.