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Presented by the Post-Acute Care Collaborative
How to spark post-acute growth in challenging times
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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Presented by the Post-Acute Care Collaborative
How to spark post-acute growth in challenging times
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
6
Longstanding trends are accelerating due to Covid-19
Interest in shifting more care to the home. New care models and
regulatory flexibilities have enabled a short-term shift to the home, but long-
term growth will likely occur outside of Medicare home health.
Fears around SNF solvency and viability. The outbreak news,
along with continued decline in occupancy, has exacerbated existing
concerns around SNF survival.
Continued need for acute/post-acute collaboration. More than ever, acute/post-
acute providers have a shared interest in supporting throughput and quality goals.
But resource limitations mean the investments must be right-sized.
Pre- and post-Covid-19 market dynamics look similar
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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Source: “Long Term Care Closures Mount as Cov id-19 Exacerbates Financial Shortf alls,” AHCA/NCAL, Nov 2020,
https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/Long-Term-Care-Closures-Mount-As-COVID-
19-Exacerbates-Financial-Shortf alls.aspx; 2020 Adv isory Board surv ey : Financial impact of Cov id-19 on post-acute care.
Post-acute providers facing increased financial strain
70.8%
16.7%
12.5%
Decreased
Stayed thesame
Increased
Impact of the Covid-19 on post-acute organizations’ revenues
2020 Advisory Board survey of acute/post-acute organizations The long-term care sector has long faced
financial struggles, but the pandemic has
exacerbated these severe
challenges…Coupled with the current
need to acquire more personal
protective equipment (PPE), regular
Covid testing and staffing needs
associated with the pandemic, these
facilities are being pushed to the brink.
American Health Care Association and
National Center for Assisted Living
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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Source: 2020 Adv isory Board surv ey : Financial impact of Cov id-19 on post-acute care.
Most providers predict volumes will recover by 2022
22%
26%35%
9%
9%
Timing will depend on
vaccine availability
Volumes have already returned
to pre-pandemic levels
In 1 to 2 yearsWithin the next year
I don’t expect volumes to return
to pre-pandemic levels
Post-acute provider predictions on return to pre-pandemic volumes
2020 Advisory Board survey of acute/post-acute organizations
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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Don’t just stand by; growth won’t happen on its own
Even in a post-vaccine world, a slew of barriers hinder post-acute expansion
Covid-19
induced barriers
Ongoing
barriers
Consumers question quality and
security of post-acute care amid outbreaks
Adoption of home-based care
models have changed existing referral patterns
Payers and value-based
programs incentivize lowering post-acute use
Existing reimbursements
structures don’t leave adequate room for innovation
Workforce shortages limit
service and clinical expertise expansion
Patient demographics changing
due to Covid-19 fatality rate with older adults
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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The basic growth formula isn’t changing
Identify market priorities
related to post-discharge care for local stakeholders
Make the right pitch
to successfully convey to stakeholders your ability to meet those priorities
Develop a service offering
to fill market gaps related to stakeholder priorities
The fundamental steps to volume growth and sustainability remain true
1 2 3
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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You are what the market believes you to be
The role you play = The problems the stakeholder believes you can solve
Hospitals see us as:
A release valve for
acute care capacity
A lower-acuity
setting
Payers see us as:
An opportunity to
minimize costs
Providers who
deliver care that can
limit long-term needs
Patients and families see us as:
The next step
in recovery
A long-term housing option
for patients that families
can’t care for at home
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
12
Hospitals’ view: you are a way to preserve bed capacity
Top priorities influencing acute/post-acute collaboration
Reducing
readmissions
Accelerating
throughput
Ensuring
downstream quality
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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Payers’ view: you are an opportunity to cut costs
Top priorities influencing payer involvement in post-acute care
Right-sizing
post-acute use
Expanding home-
based options
Ensuring strong
clinical outcomes
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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Patients’ and families’ view: you are a step to recovery
Top priorities influencing post-acute selection
Facility-based
care avoidance
Setting
reputation
Lifestyle and
visitation policies
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
15
Enhance virtual relationships with hospitals
01
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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With hospitals, same challenges but added difficulty
Challenges
Optimize virtual
relationships
Competition with other
post-acute providers
Lack of hospital interest in
collaboration
Lack of hospital bandwidth
for collaboration
Lack of in-person
communication
Action step
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
17
Covid-19 has changed how we reach hospital partners
Traditional marketing channels New marketing methods due to Covid-19
More focus on clinical
quality and safety
Pros of changes
Harder to change pre-existing
discharge patterns
Harder to build relationships with partners
Cons of changes
• Liaisons
• Meetings
• Website
• Tours
• Factsheets
• Community outreach
• Remote meetings
• Virtual tours
• Virtual community events
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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1. Hospital Readmission Reduction Penalty .
Translate data into value for hospitals
Hospitals view you as:
• Readmission rates for HRRP1 penalty
conditions, bundled conditions
• Throughput for bundled conditions
• Episodic cost for bundled conditions
Don’t make this common mistake: Sending a data dump.
A capacity release valve
A low-acuity setting
Key data points to share:
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
19
Prove your value to payers
02
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
20
With payers, the same challenges but new opportunities
Challenges
Lack of payer interest
Challenging to prove ROI to payers
seeking demonstrable cost reduction
Take advantage of the
opportunity Covid-19 has
created to prove value to payers
Action step
Insufficient concentration of beneficiaries of
one specific payer in each provider’s patient pool
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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1. Managed Care Organization.
Getting the chance to prove your value
Consider the plan’s
Chief Operating Officer a contact for strategic inquiries
Go straight to the top Work your way up Partner with a provider Partner with the state
Test new service ideas
on a case basis with MCO1 clinical leaders and use evidence to
request strategic discussions
Host voluntary meetings
regarding new program ideas following mandatory meetings
between the MCOs and state
Ask affiliated providers with
clout for introductions, joint meetings
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
22
1. Hospital Readmission Reduction Penalty .
Translate data into value for payers
Payers view you as:
Don’t make this common mistake: Only focusing on immediate, or short-term, costs of care.
Key data points to share:
• Provider share of MA1 volumes in
relevant markets
• Total cost of care for top diagnoses
• Healthcare days for top diagnoses
An opportunity to
minimize costs
Enhanced care to
limit long-term needs
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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Rebuild trust with consumers
03
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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Challenges of appealing to consumers are exacerbated
Challenges
Lack of consumer faith in the safety of
post-acute and long-term care settings
Lack of consumer understanding of
what post-acute and long-term care is
Rebuild
consumer trust
Action step
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
25
“Reputational restoration for the industry will be ongoing.
We’ll need to come together to remind consumers, media
and lawmakers of the innumerable benefits of living in a
senior living community and to not only reassure them that
communities are safe, but to truly live up to that promise.”
James Balda, President and CEO, Argentum
Source: “Recovering from emotional, economic effects of pandemic will dominate senior living in 2021,”
McKnight’s Senior Living, January 2021, https://www.mcknightsseniorliving.com/home/news/recovering -
from-emotional-economic-effects-of-pandemic-will-dominate-senior-living-in-2021/.
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
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Source: Konetzka RT et al., “Use Of Nursing Home Compare Website Appears Limited By Lack Of Awareness And
Initial Mistrust Of The Data,”Health Affairs, https://www.healthaf f airs.org/doi/full/10.1377/hlthaff.2015.1377?related-
urls=y es&cited-by =y es&legid=healthaf f%3B35%2F4%2F706&sid=a3df e968-bf 85-4b8c-9b94-1b172dccb6b8
Quality is extremely difficult for families to gauge
Cleanliness
Friendliness and number of staff
Activities
Visible specialization
When trying to evaluate
quality, families rely on:
“Cleanliness I would tie into the
competency of the staff. ‘Cause,
you know, if they’re not taking
care of the place, what else aren’t
they doing?
Interviewee selecting nursing
home for a loved one
© 2021 Advisory Board • All rights reserved • advisory.com Advisory Board interviews and analysis.
27
1. Hospital Readmission Reduction Penalty .
Translate data into value for consumers
Consumers view you as:
Don’t make this common mistake: Using referrer-centric terms when sharing metrics with consumers.
Key data points to share:
A step to recovery
Long-term housing
• Average length of stay
• Services and certifications held by staff
• Functional improvement metrics for relevant
diagnoses