Post-acute care providers must understand how payment is being realigned and gather market data in order to form partnerships with hospitals, healthcare business strategy experts said Thursday.
“There’s no substitute for a well-crafted value proposition that demonstrates a keen understanding of the pressures facing your target hospital and how you can become a post-acute care solution,” said Sally Rodriguez, senior manager of Avalere Health.
Rodriguez, along with Avalere Health Senior Vice President Erik Johnson, was the featured speaker for the webinar “Using Medicare Spending Data to Maximize Partnership Opportunities.”
Providers should look at a hospital’s average spending per care setting, penalties in the Medicare Value-Based Purchasing program and, most importantly, the Medicare Spending per Beneficiary (MSPB) measure, they advised.
The MSPB measures the efficiency of a particular episode, which averages about 40 days. And because it is a “rolling measure,” hospitals are constantly graded on a curve, Johnson said. Therefore, no matter how well a hospital performs, they will continue to lose payments if they aren’t improving faster than their peer hospitals, he said.
To help remedy this situation, Johnson and Rodriguez advise PAC providers to build strong partnerships with physicians, case managers and other professionals with relevant work experience.
“You really want to study several data sets internally in order to understand the hospital’s position,” Rodriguez said. “Once you have collected all the pertinent data related to the hospital you are studying, the next step is to incorporate the data into your value-proposition story. The spending per beneficiary data is one critical piece of a value proposition which must address the three key levers.” Those are reducing readmissions, reducing length of stay or shifting to a lower-cost setting.
“The hardest part is just getting in the door sometimes,” Rodriguez acknowledged. “Have your metrics in place and communicate a good value story that can grab people’s attention quickly and easily.”
To listen to an archived version of Thursday’s webcast, click here.
