Beware these pitfalls of acute, post-acute care alignment

Friday, March 13, 2015

BURTONVILLE, Md. – Sure, the push by hospitals and health systems to reduce readmission rates has created opportunities for post-acute care providers. But post-acute providers should be careful not to take on too much responsibility, says healthcare attorney Elizabeth Hogue. Here’s what Hogue had to say about navigating the Wild West of acute and post-acute care alignment.

HME News: As post-acute providers seek to create partnerships with hospitals and health systems, what are the pitfalls they face?

Elizabeth Hogue: There are a number of practical ones. I think there’s a tendency on the part of the hospital to look at post-acute care providers and say, “OK, this is your responsibility.” The truth is, we still don’t know how to reduce readmission rates. We think it has to do with discharge planning at the hospital. We think it has to do with transition care services. It’s beginning to look like it has something to do with caregiver education. But we don’t know. So post-acute providers need to be careful about allowing hospitals to dump on them.

HME: What’s the message that post-acute care providers want to convey to hospitals?

Hogue: They need to be very clear that it’s a collaboration. That’s the only way it’s going to work.

HME: So taking on too much responsibility is one pitfall. Any others?

Hogue: I’m hearing some commentators suggest a patient’s right to freedom of choice will or should go away because, otherwise, how are hospitals going to get control of readmissions? That’s a bunch of bunk. The right to freedom of choice isn’t going anywhere. Can you imagine saying to a patient, “This is where you’re going to get your post-acute care?” That dog is not going to hunt. It’s missing the point, anyway. The point is, it’s the provider’s job to engage patients in an effective conversation about post-acute care and care transitions. 

HME: But a lot of preferred provider relationships could be formed, right?

Hogue: Of course, but patient choice always trumps any of those relationships.

HME: How are you seeing post-acute providers make these collaborations with hospitals work?

Hogue: One of the things that I’m seeing work is to have designated staff members on both sides of the fence who are responsible for whatever services are involved and to contractually require that those representatives meet with each other on a regular basis. I’m also seeing that the sharing of data in both directions is key.

HME: You work with a number of different types of post-acute care providers. Who’s making the most progress in this area?

Hogue: The Medicare-certified home health agencies are, but that’s not to say there isn’t a role for other providers. The jury is still out on what works and what doesn’t, but home health agencies are successfully entering into care transition agreements and preferred provider relationships.

HME: How are home health agencies getting through to hospitals?

Hogue: Readmission rates are available and you can see who’s in trouble and who isn’t. It’s a nice approach for post-acute care providers to say, “We see you have a rate of X. Let us help you bring that down.”