We all want better outcomes for our patients accompanied by a lower cost of care. As healthcare becomes ever more complex, it is often difficult to tell where we need to focus our changes to achieve this desired outcome. This is especially true for Accountable Care Organizations (ACOs) that work to optimize value across a patient’s entire care journey, including in the post-acute care space.
Within this arena, patients’ needs are often more complex, as is the patchwork of Long-Term and Post-Acute Care (LTPAC) services, ranging from the care provided by specialty hospitals to that delivered by skilled nursing facilities (SNFs) and even community-based organizations. But there is good news: ACOs that embrace post-acute analytics can learn how and where you need to make changes to improve care and earn more shared savings.
Types of Post-Acute Analytics
To start, it is helpful to have a quick refresher on the different types of analytics that exist. Prescriptive analytics give you data about what you should do, while predictive analytics can tell you what is likely to happen in the future. Descriptive analytics can give you a stronger understanding of what has happened in the past. Meanwhile, diagnostic analytics provide a more advanced drill down, perform data discovery, mine data, and find correlations to identify the root cause and answer why something happened.
Four Benefits of Using Post-Acute Analytics in ACOs
The strategies that lead to shared savings can be complex, but one simple component of successful ACOs is having the right post-acute data. The benefits of incorporating post-acute analytics into your ACO’s strategy look exactly like some of the goals that these organizations hope to achieve:
Build and sustain high-performing SNF networks
Prevent hospital readmissions and adverse events
Reduce total cost
Earn more shared savings
Healthcare Organizations Achieving Results
Several healthcare organizations working in the post-acute care arena have a proven track record of using analytics to move them closer to the Quadruple Aim. For example, Boston-based health system Cambridge Health Alliance was able to gain confidence in their decision making and reduce their 30-day rehospitalizations by 25% in a year. Overall, PointRight’s post-acute analytics users in the ACO space have generated over $101 Million in Medicare savings to date.
Post-Acute Analytics Help You Earn Shared Savings
At the end of the day, the most important measures are improved care and better outcomes for patients. But increased shared savings is something no ACO wants to pass up either. In all, 67 percent of Shared Savings Program ACOs shared savings with CMS in PY 2020. Eighty-eight percent of two-sided model (potential for shared savings or losses) ACOs earned shared savings payments, and 55 percent of one-sided model (potential for shared savings only) ACOs earned shared savings payments. [ source: CMS.gov ]
ACOs are potentially leaving millions on the table in shared savings that could be earned by better managing their SNFs. The “formula” for getting there can be relatively simple with the right tools and support. When you can use analytics to assess the performance of your SNF Network, you can understand how your post-acute care (PAC) outcomes compare to others. Once you can understand and evaluate your readmission outcomes, you can then develop a roadmap to improve care for at-risk patients, preventing readmission through improved care management.