NIC Notes

Insights in Seniors Housing & Care

By: NIC  |  August 26, 2015

Providers Retool Post-Acute Strategies

Economic Trends  |  Ideas and Discussion


The shift from fee-for-service to fee-for-outcome payments will have an enormous impact on the financial success of providers.  And it’s becoming more and more apparent that skilled nursing and post-acute providers risk being left behind unless they move quickly to adjust to the new payor landscape. 

But what’s the best approach?

“The challenge presented by the new payment models is that they reduce the length of stay in post-acute settings,” said Mark Parkinson, president and CEO at the American Health Care Association/National Center for Assisted Living (AHCA/NCAL). “The question we face is: how can providers succeed?”

Winning strategies for the new reimbursement environment will be presented by Parkinson and other experts at a panel discussion during the 25th NIC National Conference. The Conference is being held September 30 - October 2, at the Gaylord National, National Harbor.

The panel discussion, “Opportunity Knocking: The Impact of the Changing Payor Landscape,” will take place Thursday Oct. 1 at 10:45 a.m.  Kurt Read, principal, RSF Partners, will moderate the discussion. Panelists include the AHCA/NCAL’s Parkinson; Brian Cloch, CEO, Post-Acute Network Solutions; Jason H. Feuerman, senior vice president for strategic development and managed care, Genesis HealthCare; and Adam Kane, senior vice president, corporate affairs, Erickson Living.

The panel will address topics such as referral flow, how to manage health care dollars and the operating changes needed to stay competitive.

In a preview of his Conference remarks, Parkinson noted that the post-acute care business over the last 15 years has been the foundation of success for the long-term care industry. But the average length of stay for patients is rapidly being lowered by payors. While the old reimbursement model called for a 28-day stay, the new standard is about 17 days. As a result, “Providers have more rapid turnover, and need more volume,” said Parkinson.

To remain competitive, post-acute care providers should adopt a three-pronged strategy, Parkinson said.  Providers must be able to offer high-quality care. They should also be part of the health care payments networks emerging in their local markets, whether that includes accountable care organizations, managed care groups or bundled payments systems. Lastly, post-acute providers that seek outsized returns must consider taking on the financial risk of the health care management of patients to potentially share in the savings generated by cost reductions. “Not enough of the providers are thinking about this,” said Parkinson.

No one model or approach is best, Parkinson notes. For example, some providers are forming their own managed care companies. “There are many different strategies,” he says. But, he warns, small operators that focus only on taking care of residents could get left behind.

Panelist Brian Cloch will detail innovative approaches for providers. He owns several companies in the post-acute space, including home health services and assisted living facilities. He suggests that the rehabilitation or transitional care facilities poised for success will offer upscale accommodations and hotel-like services. Cloch recently opened a new 120-bed post-acute facility in Arlington Heights, Ill. The building only provides post-acute care and features private rooms, multiple food venues and other upscale amenities. “It’s more hotel than hospital,” he said.

Panelist Cloch will also discuss a cutting edge idea— health management of frail resident populations. Though assisted living buildings usually stop short of coordinating health care for residents, such a service could help reduce medical costs and boost occupancies. “The goal is to keep residents happy and healthy—and in the building.”

Cloch’s company, Post-Acute Network Solutions, creates relationships with managed care and insurance companies, and then coordinates health care for residents at seniors housing facilities. A “care coach” is assigned to the building to manage the health of residents. The care coach, for example, can bring in medical help for a sick resident and keep the resident out of the hospital. The insurance company pays for the service.

“We manage the medical side for buildings,” said Cloch. “Care coordination is important and the insurance companies get it.” 


About NIC

The National Investment Center for Seniors Housing & Care (NIC) is a nonprofit 501(c)(3) organization whose mission is to support access and choice for America’s seniors by providing data, analytics, and connections that bring together investors and providers.

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