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QUALITY TODAY

A blog dedicated to advancing healthcare quality.

"Playing Nice with Others" is Vital for Care Coordination

Posted by Rachel Verslues on Jul 11, 2016 10:00:00 AM

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Our parents taught us at a young age to “play nice with others”. As the healthcare industry transitions from fee-for-service to value-based payments, this saying has never been more true. If you don’t play nice, you may be left behind.

In the past, there wasn’t nearly as much at stake for hospitals and nursing homes to work together, and they often found themselves at odds or as we could call them as children, “frenemies”. Both parties tend to think about their own needs and disregard the impact of their actions on the other side. Plus, there is a good amount of blaming each other, especially when it comes to the issue of who is responsible for hospital readmissions.

Read: Frenemies No More—5 Steps to Improve Hospital and Nursing Home Communication

Improving communication is an important first step. The days of operating independently from other provider organizations in your community are gone. Today it is about more than just transferring paperwork, it is about developing strong partnerships. Value-based care needs to be coordinated care.

Value Based NH White Paper

Hospitals and nursing homes must work closely together to improve quality of care, control costs and reduce readmissions.

The common goal of quality care is shared, but agreeing on strategies to get there is a little more complicated. That is why there must be clear communications and effective networking between the organizations. Everyone needs to be “speaking the same language”.

Not only does it improve care, it improves your bottom line.
While improving the quality of care for residents is the number one concern, there are also several financial enticements for having a strong network of care providers. New payment models are driving care coordination to the point where it is not optional. Medicare has also made it clear that it expects healthcare providers to share accountability for health outcomes and is now offering value-driven incentives for care coordination.

Certain standards of care must be met in order to earn financial incentives and reimbursements, not to mention avoid penalties. Value-based payments, bundled payments and Medicare readmission penalties are a few things that will have a financial impact. There is also Centers for Medicare and Medicaid Services (CMS) plan to roll out the Skilled Nursing Facility Value-Based Purchasing Program (SNFVBP) in 2019. The SNFVBP will pay participating nursing homes for services based on the quality of care, not just quantity of the services they provide in a given performance period.

Worse than being left behind, if you don’t “play nice with others” you may not be in business in a few years.

Sometimes, it’s not what you know, it’s who you know.
Get out into the community; establish relationships and strengthen ties. Creating a network of healthcare providers who collaborate for best outcomes for individuals in their care is the ultimate goal. Who do you have in your network? Local area hospitals, primary care physicians, home health workers, nursing staff, social workers, pharmacists—the list goes on of who you need to know to make care as coordinated as possible. It is also important that you not only know everyone across the continuum of care, but that you have a positive relationship with them. This will help ensure that everyone is on the same page regarding the care of the individual.

Read: Nursing Homes—Why Care Coordination is Like a Party

When it comes to quality and payment, one of the best ways to be successful under a value-based healthcare model is to work closely with the other care providers in your community. If you form strong working relationships with the broad group mentioned above that serve your residents, you can offer more coordinated and safer care to patients. A good way to get the ball rolling is to schedule some face-to-face meetings with outside providers. Sit down with them and trade ideas on how each side can improve care coordination. Then take the ideas and put them into action.

Care Coordination for Nursing Homes White Paper

Does your organizations have any networking tactics that have strengthened your relationships among providers? Share below. 

 

Topics: care coordination, value-based care, nursing homes

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