Post-Acute Partnerships – Beyond Year One: Lessons from Baystate Health & Cleveland Clinic

Preferred post-acute networks have emerged as a strategy to reduce hospital readmissions. An earlier blog entry discusses creating a preferred provider network (5 tips from the Cleveland Clinic and Baystate Medical Center to create a preferred SNF network). In this entry, we share lessons learned from post-acute leaders from The Cleveland Clinic and Baystate Medical Center on how their organizations engage their preferred post-acute provider networks post-implementation.

Beyond Year 1 – Sustaining and Improving a Post-Acute Provider Network

Hospitals and health systems throughout the US are partnering with post-acute providers to improve post-acute outcomes. But after your network is set-up, how can you sustain and improve your preferred provider network?

As part of the CarePort Post-Acute Thought Leadership Series, executives in the post-acute practices at The Cleveland Clinic and Baystate Medical Center shared how their organizations successfully engage preferred providers on an ongoing basis, post-implementation.

Here are three key recommendations that they have for other post-acute professionals:

1. Define ongoing roles and responsibilities for a collaborative care model

The Cleveland Clinic developed an integrated collaborative care relationship as part of the broader development of the Center for Connected Care, which brought together the Cleveland Clinic’s home and transitional care services under the Center. The Cleveland Clinic placed medical staff in its “Connected Care” skilled nursing facilities to manage Cleveland Clinic patients. Co-management of patients, for example, included working together on discharge planning and utilization reviews. Additionally, each partner committed to standing joint quality committee meetings where leadership from The Center for Connected Care and Connected Care SNFs would come together to review readmissions and implement quality improvement recommendations.

For Baystate Medical Center and its preferred providers, a partnership model has worked. Like the Cleveland Clinic and its Connected Care providers, Baystate and its preferred providers participate in ongoing data sharing and joint quality improvement meetings. With respect to post-acute patient management, this is conducted on a more informal basis rather than through staffing health system medical staff at SNFs.

2. Transparency drives quality improvements for all participants in the network

Cleveland Clinic and its partners hold routine joint quality committee meetings that are “very transparent,” according to Dan Blechschmid, LNHA, MHA, FACHE, Regional SNF/LTACH Administrator for the Cleveland Clinic Center for Connected Care. The team reviews metrics in addition to each and every readmission.

At Baystate Medical Center, the team developed a scorecard to evaluate SNF performance. Baystate collects data routinely and incorporates the data into provider-specific scorecards evaluating facility-based, process and outcomes measures. [You can learn more on how Baystate determined what data to collect by watching “Creating Preferred SNF Networks – Best Practices from Cleveland Clinic and Baystate Health]

Baystate shares scorecards with preferred providers in a blinded fashion so that SNFs can understand their own performance as well as how they perform relative to the universe of preferred providers. Baystate regularly meets with the SNFs and has committed to sharing how certain facilities in the top quadrant were able to perform and obtain higher scores. The idea is, “the rising tide of shared best practices can raise of all boats,” according to Maura McQueeney, BSN, MPH, NE-BC, President of Baystate Visiting Nurse Association and Hospice and Post-Acute Executive at Baystate Health.

3. Share the benefits of preferred provider with patients 

The benefits of preferred providers need to be communicated to patients on an ongoing basis. The hard-work in setting up and maintaining preferred provider programs pays off when patients discharged to those facilities achieve better outcomes.

Using CarePort Guide, a patient-centered search engine for post-acute care, both Cleveland Clinic and Baystate Medical Center are engaging patients and families in the selection of post-acute providers that best meet the patient’s care needs. Preferred providers are highlighted to patients and their families within the interactive tool. At the same time, CarePort supports Medicare patient choice by presenting all options that match patient’s insurance, clinical needs and geography preferences.

According to McQueeney, the preferred provider network strategy has become a standard part of the patient counseling script; this ensures that patients know they have choice, while also communicating to patients in an educational way that Baystate has selected a number of facilities that have achieved specific quality standards.

Reap the benefits of post-acute partnerships

The Cleveland Clinic and Baystate Medical Center have achieved improvements in post-acute quality and cost savings through their partnerships with post-acute providers, including lower readmission rates and shorter SNF length of stay.

Baystate saw a three-day reduction in SNF stay for its Model 2 BPCI patients. The Cleveland Clinic achieved improvements in hospital readmission rates.  In spite of the fact that Connected Care SNF providers tend to admit greater percentages of high acuity patients discharged from the Cleveland Clinic main campus, their readmission rates are 10% lower in terms of absolute numbers as compared to all other SNF providers.

Next Steps

1. Learn Best Practices from The Cleveland Clinic and Baystate Health

Hear Leslie Vajner, Administrative Director at the Cleveland Clinic Center for Connected Care, and Maura McQueeney, President of Baystate Health VNA & Hospice discuss how their health systems have maintained preferred SNF networks post-implementation.

  • How has the preferred provider network evolved since its initial set up?
  • What ongoing activities to engage in with your preferred providers?
  • What have been the lessons learned / biggest challenges post-implementation?

2. Ask for a Complimentary Report on SNFs in Your Area

Are you investigating ways to create and sustain an accountable post-acute preferred provider network in your area? CarePort can help you get started with a complimentary report showing the readmission rates and average length of stay results from post-acute care providers in your area.