Every day, patients receive their discharge papers and leave the hospital—and often, the hospital staff hold their collective breath and hope for the best, considering the amount of information a patient is given and following an acute admission.
While they certainly have the patient's best interests at heart, their interest isn't purely altruistic. Due to changes in reimbursement in recent years, hospitals can be on the hook, financially speaking, if those patients rebound—that is, if they return to the hospital and need readmission within 30 days.
Even when the hospital staff have done their job well on the inpatient side, the patient will need care after discharge. This is called post-acute care, which establishes a transfer of responsibility from the patient to a care team, with the goal of achieving the best possible outcome for the patient.
Ideally, the patient has a strong support system in place to help them recover after leaving the hospital, and remain compliant and understands the discharge plan of care. The patient will be discharged and slowly but steadily rebuild their strength and return to their normal activities of daily living.
However, hospitals can't just leave that to chance. They must be more actively involved in managing their patients to ensure that they will receive the most appropriate post-acute care. It can be quite challenging, but the payoffs—healthier patients, improved quality of care, optimal outcomes, and reduced costs—makes it a worthwhile goal.
Opportunities in providing post-acute care
Post-acute care is a booming business. According to a 2014 report from Deloitte LLC, post-acute care providers received more than $62 billion in Medicare funds in 2012—and the total spend has continued to march upward in recent years.
One of the most important things that healthcare organizations can do is create strong partnerships with post-acute care providers, which can include home health agencies, inpatient rehab facilities, long-term acute care hospitals, and skilled nursing facilities.
Or, they can create their own service offering in this area. As the Deloitte report noted, the post-acute care business is an opportunity for growth for many healthcare organizations to expand their capabilities and grow. It can position hospitals to be better equipped to provide value-based care across the continuum, and it can provide new revenue streams while also preventing costly readmissions.
The choice of site for those patients receiving post-acute care matters more than one might realize. Organizations can reposition post-acute care providers to prevent avoidable readmissions from happening. Caregivers or providers in a particular setting may be better positioned to monitor their at-risk patients, identify warning signs of future acute care incidents, and intervene, preventing those symptoms from becoming severe enough to warrant a costly readmission to the hospital. Fittingly, choosing the right setting is a key tenet of eviCore's Post-Acute Care approach.
eviCore's Post-Acute Care solution, which applies an evidence-based case and care management system that can tailor the care provided to each patient based on their clinical needs, also emphasizes the importance of maintaining an evidence-based, patient-centered approach through all the transitions of care.
Of course, it's possible that efforts to reduce healthcare spending could affect the post-acute care sector. However, consider current population trends—the number of people over age 65 in the United States is expected to double to 81 million by 2040. Demand for this type of care is expected to increase over the next two decades as the population of people who will need post-acute care continues to grow. And most experts believe that this extraordinary growth in the potential market will give added incentive to post-acute care providers to deliver high-quality, efficient care focusing on outcomes not volume.