Published on March 14, 2014
ACHE Meeting Hershey 2/25/2014 Integrating Acute to Post Acute Care Settings 1
2 Mark Freeburn: Chief Executive Officer, HealthSouth Rehabilitation Hospital of Mechanicsburg Don Yoder: Chief Development Officer & Chief Compliance Officer, Vibra Healthcare Gary Scicchitano: Vice President, Visiting Nurse Association of Central PA; President, VNA Private Duty Mauree Gingrich: Representative, Lebanon County 101st Legislative District, Pennsylvania House of Representatives
2 Home Health CareHome health organizations can be your best friend in reducing hospital readmissions and ensuring quality of care Work with a quality home health care companies who will be your partners. Build the relationship and it will pay big dividends • Communication is everything! • Share important patient information • Work on developing protocols that ensure quality care and meet the needs of the patient. Don’t take shortcuts. • Home health care companies can be your eyes and ears in the patients home. • Home health can also be your first line of defense and will keep those “frequent flyers” from returning to the ED or hospital • Home health can get your excellent results!
2 Inpatient Rehabilitation Hospital The IRF model has been stable for years but now faces the threat of moving to 75% of patients meeting the IRF-DRG compliance What we do know already • The larger the 13 IRF-DRGs the patient population the better the IRF is positioned • The IRF needs a good relationship with our referral hospitals so they will allow us to work with their patient populations where they want new care delivery models. • We are going to face managed care case managers denying patients we had previously treated and sending them to SNF level of care. We need to monitor this and when we believe we cannot defeat this we need to reinvent our care to compete with this site neutral threat. • There will be new patient types that we will be able to treat in the non-compliant 40% patient population - as we understand which patients we may need enhanced clinical skills to treat these new patients • The IRF will need a SNF level of care to work with on a close basis. (This will allow us to better manage the site neutral threat) • The IRF should be the primary level of care for the IRF-DRGs used to defeat readmissions and take direct admissions from other sites and levels of care • We will need to deal with placement of patients after our care delivery – care into the home and back into the STACH Medical Home
3 Long Term Acute Hospital The model that is evolving from the January 2014 law will take another 6+ years What we do know already • All LTACHs will have a ventilator patient population • All LTACHs will have a good relationship with their referral hospitals so they can work with the ICU patient population (3 days in the ICU and send to LTACH) • The larger the LTACH – PPS population (the previous mentioned bullets) the more IPPS patients you will be able to work with to reinvent care. (50% of discharges in 2020) • There will be new patient types that we will be able to treat in the IPPS section of LTACHs – less that 25 day population sector – clinical skills will need to be enhanced. • Most LTACHs will develop a SNF level of care in their buildings or one we can work with on a close basis. (several days and send to SNF or help defeat readmission) • The LTACH should be the primary level of care used to defeat readmissions with the IPPS level of care and manage chronic care conditions for your patients • LTACHs will move to this level of care by October 2015 • If they cannot get enough LTACH-PPS patient population we will need to repurpose your building with other PAC levels of care. - moving to each hospital having all levels of care. • LTACHs will need to deal with placement of patients after our care delivery – care into the home and back into the STACH Medical Home
31 Healthcare Legislative Activity The primary focus at the state level this year will be in several areas • Healthcare Exchanges • Medicaid Expansion • Tele-health expansion – reimbursement and scope of service • Licensing Laws – who is allowed to do what and get paid for it.
32 THANK YOU!