Proving that the ACA challenge can be met
If there's one question sure to put a provider on edge these days, it's this: How do I transition my facility into the world of accountable care organizations?
As most operators will readily admit, ACOs potentially present a steep learning curve and trouble around just about every corner. Small wonder it's an approach to care and operations that many operators don't even want to think about.
Yet the shift will be required for many. And for those who want to see how it can be done, look no further than New Jersey. There, a consortium of skilled care facilities, doctors and hospitals are showing that subacute care can be delivered at a higher level, in fewer days with a reduced risk for hospital readmission. Oh, and this is all being happening while Medicare costs go down.
The Atlantic Accountable Care Organization (AACO) and Optimus Healthcare Partners launched the effort last year. In just six months, mean performance across all measures saw a remarkable 27% increase. Just as stunning: AACO trimmed care costs.
“Never before have we seen nursing facilities make such vast improvements in this short amount of time,” said Loretta Kaes, who is director of quality and clinical services for the Health Care Association of New Jersey.
AACO and Optimus began by identifying numerous quality measures to address. These included pressure ulcers, influenza immunizations, pneumococcal (pneumonia) vaccinations, self-reported moderate-to-severe pain, and use of anti-psychotics.
Before the collaboration began working with 61 facilities, only 20% of the clinical quality scores were at or above the state average. The figure among participants now? Fully 100%
Moreover, average lengths of stay are down from 25.3 days to 21.2. Hospital readmissions fell to 14.8% for those in the program (compared to the 16.8% state average).
But the figure most likely to grab Uncle Sam's attention is this: The cost of providing care to Medicare beneficiaries fell by 1.8%. That might not sound like much. But those numbers can add up quickly.
Not surprisingly, the initiative is attracting more New Jersey facilities that want to participate.
Is this approach the best answer for the future? Not necessarily. But given its demonstrated ability to improve care while reducing costs, you can bet it's a solution that will resonate far beyond the Garden State.
John O'Connor is McKnight's Editorial Director.