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March 20, 2018

Build a Preferred Post-Acute Network in Seven Steps

Amidst pressure to reduce readmissions, improve care quality, and increase patient engagement, providers have been looking to implement strategies to help keep patients from returning to acute care. One of these strategies is building a preferred post-acute network.

Twenty percent of Medicare patients are discharged to a skilled nursing facility (SNF) following a hospital stay. Hospitals and health systems have found that closer management of the post-acute process not only keeps patients out of the hospital, but also strengthens care coordination and improves outcomes. An effective preferred network can pay powerful dividends to providers, patients, and payers alike. If you've been thinking about building out a preferred network, but aren't sure where to start, follow the seven steps below to help you get started.

Step 1: Evaluate Your Capabilities

An important first step to building out a preferred network is to look internally to determine if you have the resources to support one. Building a list and managing your top post-acute providers takes time, as well as personnel. Commonly, the responsibility of building a preferred network lies in the hands of discharge planners, care coordinators or individuals in innovation roles. Many larger systems and hospitals have formed roles specifically for managing post-acute partners. Additionally, leveraging and integrating technology into the process of running a preferred network will be an important piece.  

Step 2: Build Morale

Organizations that successfully manage preferred networks consistently have internal buy-in.  Spend time pulling numbers, demonstrating the benefits, creating roles, and building morale to make sure all parties are engaged.

Step 3: Distribute RFPs

Even before establishing a preferred network, a sizable health system will work with hundreds of post-acute providers. A best practice approach is to start to review quality metrics to narrow down the list and determine from which facilities you want to solicit applications.

Step 4: Evaluate the Facilities

Once you have received proposals and applications, it’s time to evaluate the potential facilities. A few key metrics to consider include mortality, census, readmissions, average length of stay, and geographic coverage. Additionally, in-person visits and interviews help to determine which post-acute providers will be the best partners. Seeing the facility, meeting providers, and hearing them talk about their services will give you a better sense of how patients will experience care in their facility.

Step 5: Make Your Decisions

When making final decisions about which providers will be in your preferred network, take into account your entire patient population. You’ll want to present them with a variety of options. Some things to consider are specialty programs, activity offerings, and visitation rules. The number of post-acutes chosen will vary from system to system. Some health systems may choose 10 to 20, while others may choose 50 to 100.

Step 6: Create a Two-Way Partnership

Once you’ve finalized your preferred network, the next task is to establish a collaborative relationship. Preferred networks should be approached as partnerships. The goal is to work alongside the post-acute facilities to ensure continuity of care for your patient population. True care coordination is a two-way street.

Utilize bi-directional tools that allow communication and critical information to flow freely between acute and post-acute facilities. With Pings and Stories shared in real time between facilities–from ACOs to hospitals to home health agencies–PatientPing’s platform is one tool that can help facilitate this two-way communication. When building out their PAC networks, some health systems make implementing this care coordination technology a requirement. 

Step 7: Keep Improving

Ongoing program evaluation is necessary to maintain an optimized preferred network. Many health systems continue to refine their lists of post-acute providers after gaining more insight through their partnerships. Others will simply replace providers as other potential facilities’ performance metrics improve. Either way, your preferred network should be periodically evaluated and updated.

Stay tuned for our next blog about managing and maintaining a preferred post-acute network.

Check out our Four Questions Series with Houston Methodist Coordinated Care to learn how they use PatientPing to better manage their post-acute network.

Tagged: Care Coordination, Healthcare Providers, healthcare, skilled nursing facility, payer, hospitals

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