4/22/2018 Redesign and Reimage Long Term Care for the … is Time for... · 4/22/2018 1 This document is for general informational purposes only. It does not represent legal advice

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This document is for general informational purposes only.It does not represent legal advice nor relied upon as supporting documentation or advice with CMS or other regulatory entities.

© Pathway Health Services, Inc. – All Rights Reserved – Copy with Permission Only - 2018

Consulting | Talent | Training | Resources

Redesign and Reimage Long Term Care for the FutureLisa Thomson

Chief Strategy and Marketing Officer

www.pathwayhealth.com






Disclosure of Commercial Interests

We consult for the following organization:

Pathway Health

Lisa Thomson, Chief Strategy and Marketing OfficerSue LaGrange, Director or Education

Pathway Health is a professional management and consulting organization serving clients in the long-term and post-acute care industry.




Health Care Landscape Change

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Macro Level - Change

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© Pathway Health Services, Inc. – All Rights Reserved – Copy with Permission Only - 20184/22/2018

Continuum of Care

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Continuum of Care • Acuity

• Clinical Capacity

• “Quicker, Sicker, Faster”

• ALOS

• Clinical Competency

• Clinical Integration

• Partnership, Networks, Payers






Legislative and

Regulatory

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Legislative and Regulations

Affordable Care Act IMPACT Act

Protecting Access to

Medicare Act (PAMA)

Value-Based Purchasing

(VBP)

Quality Reporting Program (QRP)

Requirements of Participation

National Quality Strategy Medicaid Reform






ROP/COP

• Skilled Nursing

• Home Care

• Inpatient Rehabilitation Facilities

• Acute Care (IPPS)

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Quality Expectations

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Quality Measurement

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• SNFVBP

• SNFQRP

• NQF

• RoP

• CASPER

• 5 Star






Quality Measure

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Numerous Readmission Measures

SNFRMSNFPPR

SNFQRP(RM)SNFQM (Short Stay Readmission and

ED) Five Star






Common Threads from CMS

Link payment, referrals and qualityProviders accountable for outcomes & costs

Episodes of CareDischarges

Partnerships, Networks, Systems Transitions of care Clinical Paths/SystemsMedication ReconciliationAdverse events and HAC/HAIPerson centered care

Resources with patient needsDisease State ManagementChronic Diseases

Hospitalizations

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Organization Data






The Link

ALOS

Readmission

Disease State

Quality Measures

DC to Community

Alignment with Partners

Data = Quality!

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QM and Financial Impact

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VBP and

Payment Models











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Payment Model Expectations

•Performance based pay

•Data, Data, Data

•Quality metrics

•New‐Performance Measures

•Standardization of data

•Risk Arrangements

•Publicly Reported Data






New Consumer






New Consumer

SatisfactionNeeds and expectationsNew care delivery

Access to information – DataChoices

Health planProviderPhysicianServices

Patient/Consumer centricPartner –integrated customer engagement strategy – the future!

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New Consumer

Seeking Value

Moving towards “transactional sale”

Look trough a different lens

Empathy and Perception

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Empathy: The Human Connection

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Source: Cleveland Clinic ©






Workforce

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Workforce Challenges

• Work force shortage

• Recruitment and Retention






Workforce Challenges

Multi generations

Communication Strategies

Competency Expectations

SME

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PAC Leadership and Success

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Readiness for ChangeOperations and Clinical

Organization Data Strategy

Strategic Relationships

Realign and Redesign






Market vs. Medicine: America's Epic Fight for Better, Affordable Healthcare

David W. Johnson






Change is the Norm

• Efficiency and Effectiveness

• New Competitors

• Targeted Solutions Reach new markets

• Collaboration

• Differentiation

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Business Model Segmentation

• Assess

• Standardize care protocols

• Review and reduce performance variations

• True operating costs

• Preparation for Value based care

• Play to strengths

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Strategic Visioning 4/22/2018






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Leading Through Change

• Understand

• Vision

• Communication

• Collaboration

• Outcomes

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Innovate and Create

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Innovation Foundation

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• Engage technology• Leverage brain power within• Invest in leadership• Clinical leader redesign• Redeployment of workforce• Redesign work flows • Its not just PPD’s

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Innovation Thoughts

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• APM adoption – a must!• Disease state niche• Customer care model

• Reconceptualize the customer

• Integrated Care Models• Chronic Care Management Model• Comfort and Recovery Suites• Admission Suites






Be the Change!

“Change is the law of life and those who look only to

the past or present are certain to miss the future”

– John F. Kennedy

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Redesign and Reimage Long Term Care for the FutureLisa Thomson

Chief Strategy and Marketing Officer

www.pathwayhealth.com

Documents

4/22/2018 Redesign and Reimage Long Term Care for the … is Time for... · 4/22/2018 1 This document is for general informational purposes only. It does not represent legal advice