How Data Can Help Healthcare Organizations Grow Their Preferred Provider Network

Hospitals that use a preferred network of post-acute care facilities reduce their readmission rates four times faster than hospitals that don’t. A recent study has found that these providers were able to cut readmission rates from nursing homes by 6.1 percent between 2009 and 2013. Hospitals that did not have a network saw only a 1.6 percentage drop in readmissions.

Another study, this one by the Journal of the American Medical Association, found that hospitals that were subject to penalties under the Hospital Readmission Reduction Program (HRRP) had greater reductions in readmission rates compared with non-penalized hospitals.

Readmission rates for Medicare beneficiaries suffering congestive heart failure averaged 22 percent from 2011 to 2014, down from 24.5 percent from 2005 to 2008, according to a Kaiser Family Foundation analysis of CMS data. Readmissions for pneumonia patients fell from 18.2 percent to 16.9 percent during the same period.

However, there is concern that momentum is stalling. Between 2013 to mid-2016, there has been no more than a 0.1 percent reduction in readmission rates on average.

“Establishing a network of trusted post-acute providers is essential to controlling costs and limiting readmissions,” said Saqib Akhter, CEO of Post-Acute Analytics, a company that helps health systems and providers auto monitor their patients in real time outside their four walls.

“Avoiding readmissions is all about coordinating care. Providers need to trust that their patients are receiving the best care once they leave their four walls. Post acute is the fastest growing segment of healthcare services, so clearly a focus there is essential in controlling cost. It also accounts for around 70 percent of Medicare’s variability. So, ensuring that patients are getting the right post-acute care in the right amount of time is critically important to making sure that patients have the best outcomes and receive care at appropriate costs.”

FACT: establishing a network of post-acute providers lowers readmission rates. Discover how Post Acute Analytics can help, click here to schedule a personalized discussion.

Yet, even organizations that establish a trusted network of providers cannot completely control where patients receive their post-acute care. There are a number of reasons that a patient would head to an out-of-network provider, including geographic preference and availability.

“My ideal situation would be for every provider in our community to be a preferred provider,” said LeAnn Richardson, the director of case management and transitional care for Norman Regional Health System, “in that everybody is welcome to join and collaborate with us. This gives the patient as many choices as possible.

“For this last year, the approach we took was, ‘If you want to be a provider with Norman Regional, all you have to do is use our analytics solution. Having the ability to coordinate with our post-acute providers is extremely important. We communicate with them about our recommended care plan, so we can all get on the same page as to our expectations for care.

“The system we use is Post Acute Analytics. Without that tool we would not have reduced our length of stay at skilled nursing facilities (SNF) by 30 percent. Without that tool we would not be able to identify certain SNFs and be able to reach out to them. It allows us to see things that we were not previously able to see and establish open lines of communication.”

“Through “Anna,” Post Acute Analytics’ technology platform, we can advise on the best processes and insights that are available in real-time to make sure that patient goals, with quality and cost, are achieved,” said Akhter. “Providers are able to see real-time patient total-cost-of-care, how they’re trending, whether they’re in the black or the red as it relates to each patient, patient outcomes, and high-risk triggers where they need help so physicians can intervene in real-time. The outcome of all that is better patient care at lower cost.”

“We would love to get all of our providers on Post Acute Analytics,” said Richardson, “to establish a streamlined system of communication and keep patients out of the emergency room and avoid readmissions.

“A rising tide raises all ships.”

Learn how Post Acute Analytics can help open lines of communication between you and your post-acute providers. Click here to schedule a personalized discussion.

Leave a Reply