For health plan leaders tasked with finding ways to manage the cost and quality of care delivered to their members, it is frustrating when patients with nearly identical diagnoses and levels of function follow different courses of treatment.
Nowhere is this truer than in post-acute care. In 2013, the Institute of Medicine (IOM) identified post-acute care spending as the primary driver of regional Medicare spending variation. In fact, the IOM report suggested that eliminating post-acute care variation would decrease the overall variation by 73%.
The root of this variation is often a mix of supply-driven demand and misaligned incentives. Areas of the country with high concentrations of long-term acute care hospitals or inpatient rehabilitation facilities often have much higher utilization rates, even if a skilled nursing facility or home health provider could provide care comparable in quality and at a much lower price.
So, what key metrics or statistics should a health plan use to assess its potential to better manage post-acute care?
Here are some ideas:
In addition to these metrics, companies like mine are introducing new measures that will help both providers and health plans better manage post-acute care. NaviHealth’s proprietary assessment technology, nH Predict, draws from a database of more than a million patient outcomes.
Each patient is different, but by identifying similar patients, our predictive analytics can help set expectations for recovery. These personal-level goals are key to ensuring that a patient receives the appropriate therapy and medical care. Our assessment technology can also detect variance between predicted functional recovery and actual functional gain. Variant metrics levels the field, reducing the risk of “cherry picking” healthier patients while recognizing providers that consistently provide the right therapy and medical care.
Empowering care teams to match patients to the right level of care, in the right place, at the right time is critical to success in a value-based care environment. But these factors can’t be managed without the ability to measure them, and that’s the foundation upon which efficiency in health care rests.