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What, exactly, is a narrow post-acute network?
Some hospitals have begun forming narrow post-acute networks in which they utilize and perhaps even contract or acquire the “best post-acute providers.” Preferred networks represent an aggressive new strategy by hospitals to gain more control over quality and costs in the largely independent skilled-nursing facility (SNF) sector.
Health systems already using preferred networks have developed criteria for selecting SNFs using state health and safety reports and quality measures reported to Medicare. This includes how well nursing facilities prevent pressure ulcers, manage pain and provide vaccines. Hospital officials also scour Medicare billing data to review facilities’ average length of stay and what percentage of patients return to the hospital within 30 days.
Here are some other criteria that have been used by accountable care organizations (ACOs) as they build out their continuing care networks:
Discharge at least 60 percent to the community following subacute care
Ability to share information electronically
Narrow networks may be a quick solution worth trying, but do they offer the best long-term solution for both providers and patients?
While acute- and post-acute providers share the goal of avoiding unnecessary inpatient stays, a hospital’s facilities, protocols and standards are very different from those of an SNF. And the communication gap between hospitals and nursing facilities often is larger than anyone ever realized.
In a word, technology. It is more important than ever before that hospitals be able to examine the full range of options available in the post-acute community in order to optimize the care patients will receive post-discharge. Rather than narrowing options for discharge planners, patients and families, better long-term outcomes could be achieved by leveraging technology and data to guide post-acute decision-making.
By keeping the network broad and using technology to filter information, finding appropriate care at the right time for patients can more effectively be accomplished. Reliance on technology rather than narrow referral patterns can also allow members of a care team to focus attention on those patients at greatest risk for readmission, enabling early interventions and potentially eliminating return acute care visits.