James M. Berklan, McKnight's Editor

Actress Ethel Barrymore once shrewdly noted: The best time to make friends is before you need them.

Sometimes long-term care providers struggle to find meaning in the signs that are strewn in their path. Whether it’s legalese, regulatory gobbledy-gook or some form of bureaucracy, uncertain messages confront providers seemingly every day.

There is one message, however, that anyone staying awake recently could not have missed. The siloed provider is fading away — and it’s not by accident.

When the marketplace isn’t organically weeding out weaker or just plain smaller players, the government seems to be pushing it.

Now, more than ever, as a Beatles tune famously put it, is a time “to get by with a little help from my friends.” Actually, a lot of help would be better. 

If you haven’t noticed, accountable care organizations and bundled pay options are being pushed on you. The provider who wants to be a loner is going to have a very difficult time.

Skilled nursing operators are going to have to establish better relationships with fellow providers, up and down the line. As top operations consultant Dale Zaletel pointed out recently in a McKnight’s Fall Online Expo session, better relationships are going to be needed with hospitals, physicians and managed care companies.

There is little question that managed care is going to become a dominant player. Providers are going to fare better if they can bring their own mini-networks of caregivers to the table.

Ultimately, physicians will hold the key to long-term care providers’ prosperity, Zaletel believes. They will drive business to providers within a larger network, whether that means to hospitals or post-acute/LTC providers. “Identify who the key physician groups are and get them involved in your center’s operation,” he advised.

A former hospital exec himself, Zaletel notes that PA/LTC providers should foster friendships not only with hospitals but along the whole continuum of care. The long-term care provider that doesn’t secure firm relationships with therapy, home health and other complementary services will be the provider left out in the cold.

Prepare now and make the right kind of friends. This goes far beyond power lunches. And even though many programs fostering greater coordination are just in pilot phases, you need to be doing this uber-networking now.