1. From Provider to Consumer Long-term Care and the Golden Years

2. I’m very pleased to be here. Let’s face it, at my age I’m very pleased to be anywhere. ----George Burns Long-term Care

3. Improving Medicare Post-Acute Care Transformation Act of 2014 IMPACT Act of 2014

4.  Standardization of Post-Acute Care Data Assessment data Patient data Quality measures Resource use Other Source: THE DISTRICT POLICY GROUP Impact Act of 2014

5. 3 Phases Phase 1 – PAC providers report data Phase 2 – Feedback reports from HHS Phase 3 – Public reporting on performance Source: THE DISTRICT POLICY GROUP Reporting the Data

6.  MedPAC to recommend a PPS (Prospective Payment) Base payment on patient characteristics rather than the facility Accounts for clinical appropriateness Incorporates assessment data Looks at integration – motivating greater coordination on a condition/procedure between hospital and PAC Source: THE DISTRICT POLICY GROUP Payment Methodology

7.  Access to care and choice of setting  Expenditures  Facility value  2% penalty Source: THE DISTRICT POLICY GROUP MedPAC’s report

8.  Secretary of HHS to do studies: Socioeconomic status Race Health Literacy Limited English proficiency Source: THE DISTRICT POLICY GROUP Improving Payment Accuracy

9.  Declining Average Length of Stay  Higher Acuity  Complex  Patient - difficult to navigate the process Source: ANNALSOFLONGTERMCARE.COM Transitioning Patients from Acute to Skilled Care (SNF)

10.  Patient has free choice  A list of available facilities  CMS updated guidelines – provide a more formal and written discharge planning process  CMS Nursing Home Compare website Source: ANNALSOFLONGTERMCARE.COM Transitioning Patients from Acute to Skilled Care (SNF)

11.  SNF visit by family  CMS emphasis on early evaluation of discharge needs  Education of care team  Guide family and patient Source: ANNALSOFLONGTERMCARE.COM Transitioning Patients from Acute to Skilled Care (SNF)

12. So, if I’m a hospital, I will be able to run a SNF better than those stand-alone facilities? A.Yes, hospitals know healthcare B.Of course, the acuity is lower in a SNF – no problem C.No, not necessarily, SNF is a different game D.A & B Source: DHGLLP.COM Acute Care and Skilled Care (SNF)

13. # of facilities CMS STAR RATING ****** and above Hospital owned SNF’s 2229%418%1673% Non- Hospital owned SNF’s 39072%297%35491% Who manages a SNF better? Source: DHGLLP.COM

14. SNF’s agree and work on: quality standards, data, services avoidable hospitalization.  Banner Health – selected 34 out of 90  Atrius Health – included 35 out of 100  Partners Healthcare – took 47 out of 140 Source: MODERNHEALTHCARE.COM; HHN.MAG.COM Creating Select Networks

15. Before: “These are the ones that are close to your house, pick one of your choosing.” Now: “These are the ones that we work with and are trying to reduce readmissions, and we have a relationship with them.” Source: HHN.MAG.COM Picking Favorites

16. Why?  Readmission penalties  Capture more of the healthcare dollar  Manage population health  Reduce cost Source: HHN.MAG.COM; DHGLLP.COM Acute Care and Long-term Care Working Together

17.  Shorter length of stay  Hospital readmissions are lower Source: MODERNHEALTHCARE.COM Results of the Networks

18.  Post-acute geriatric specialist help acute staff  Respiratory Therapists (LTACH) - help in IP  Wound Care – help OP wound clinic Source: ADVISORY.COM What do they actually do? (Use your available resources)

19.  Hospital and SNF physicians – tapering meds  Training SNF staff on managing behavioral patients  Acute medical center partnered with home care group that provided transition guides Source: ADVISORY.COM What do they actually do? (Use your available resources)

20.  Acute does not equal Post Acute – get an expert to help you be successful  Read the Impact Act of 2014 – learn the requirements and what to do  Find ways as an acute care system to partner with post acute providers and increase the value of your health system Takeaways

21. I don’t feel old. I don’t feel anything until noon. Then it’s time for my nap. ----Bob Hope Long-term Care

22. Contact Information