Daily Editors' Notes

Time to put data into your hospital relationships

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James M. Berklan, Editor
James M. Berklan, Editor
Smart providers have not taken their eye off the ball during the ballyhoo over the Affordable Care Act and whether the Supreme Court would leave any of it intact. They know the door was opened long enough, one way or another, to glimpse the future.

That would be a future with bundled payments forcing long-term care providers to strengthen relationships with other providers. How hospitals, doctors and others view a long-term care facility will be more critical than ever in the future.

While that might conjure visions of more three-martini lunches and enhanced golf games, it really means another hard truth: You're not going to be able to escape the numbers. At the end of the day, it's going to come down to lengths of stay and cost of care.

Because hospitals will have to share Uncle Sam's booty with other providers up and down the line, they're not going to want to do business with you if you don't take good care of your post-acute residents. And you're going to have to have the data to back up why you're the best choice.

As former head of the Centers for Medicare & Medicaid Services Donald Berwick, M.D., said Tuesday, the train has already left the station when it comes to reform. It's important to remember that accountable care organizations are just a product of demonstration language in the healthcare reform bill. Whether they survive or not — in any of the visions that various parties have bandied about — is unknown. The government just wanted to kick the tires on some new ideas.

Some hospitals are willing to just wait it out until a basic bundling approach is employed. As linchpins to the ACO process, you see, they're in a bind like the great-uncle who just won the lottery. They're facing an awful lot of big-eyed nephews and nieces, and sisters-in-laws and brothers-in-laws, and neighbors and long-lost friends and ex-wives, and everyone thinks they deserve a piece of the pie.

Hospitals see physicians as the wildcard. If they can't be controlled — or at least their medical costs controlled — everything else will be quite impossible. That's why some hospitals have started to purchase physician practices. There are a lot of other suitors and masters to deal with before doe-eyed long-term care providers even enter the picture.

“Very, very, very slow” is how the relationship building between hospitals and long-term care providers is progressing, as one major LTC figure described it.

Hospital readmissions data is going to be increasingly crucial to hospitals and nursing and rehab providers. That's where you can get to showing your value now.

You have to have a good handle on what your actual costs are. Anecdotes about or vows that “We provide excellent care and very satisfied residents” won't cut it. Good data collection must be put in place.

That way, when someone comes knocking on your door to learn whether you'd be a worthy care partner, you'll smartly already have the right answer in hand.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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