News and Events

The Best Defense is a Good Offense

Friday, January 22, 2016

Even up the playing field: The grounds of our ball field are shifting—and making it increasingly difficult to hold a solid position. It’s clear our strategy must change from one of defense to bringing our offense “A” game to the table. At the PointClickCare Summit 2015 Mark Parkinson, AHCA’s President and CEO as well as former owner and operator of multiple senior care communities, advised the audience that we are at the precipice of a major market shift defined by:

  • Decreases in utilization driven by reimbursement model changes
  • Networks narrowing their choices to LTPAC facilities that can achieve positive outcomes

Formulate a new game plan: Parkinson relates that AHCA has adopted an offensive position and is now actively intervening in legislation at the formation stage-- proffering suggestions on payment reforms and delivering research to the lawmaking bodies to ensure that the needs of AHCA members and the financial health and well-being of the LTPAC facilities are addressed.

Spring Training Goals: He advocates starting right now to exercise those muscles that will put that 2% withhold back in your pocket. Strengthen your core by working on your readmission rates in 2016 to ensure that you have a fighting chance to be in that top 60%. Going for the gold? Push up prevention so you can stay below that all important 10% line and have at least some opportunity to recoup a portion of your 2% withhold.

Wait for it….. Mark Parkinson suggests that we “buckle up” for the next 10 years, which, admittedly will be full of the challenges and opportunities from utilization and reimbursement changes. Those challenges will train us to be the lean, muscled, competitive athletes who win the gold ring. The silver lining—that Silver Tsunami we’ve all been waiting for-- arrives in 2030 when the predominant user of LTPAC services, persons from 80-84, grows from 6.5 million in 2020 to 10.5 million in 2030. Parkinson suggests that volume will make up for shorter stays, managed care and alternative delivery methods—but we’re going to have to improve our offensive position in order to capitalize on the Silver Tsunami.

Taking risks with the playbook: Parkinson entreats providers to “put the wind at your back” by taking on more of the risk and managing that risk with best practices, analytics and advanced technology to stem the red ink from high readmissions. We need to use every weapon in our arsenal to avoid the $4K revenue loss from each readmission in order to keep our bottom lines in the black.

Early intervention with CareConnection delivers the first line of defense. A comprehensive safety net of threshold breach alerts triggers the immediate care plan intervention that prevents readmissions. Beginning with the alert to the Caregiver during vitals capture and as the measurements are automatically transferred to your EMR, the alerts escalate to pop up on the med cart laptops, the nursing unit desktop and via email to your choices of decision making staff at the facility. This easy to use alerting system is fully customizable for single and multiple residents and can even include corporate personnel, NPs and physicians.

Click here for the Case Study “Prevention Begins with Intervention”.