Kansas Association of Healthcare Executives Article

Integrating Acute Care with Post Acute Care  

By Rod Corn FACHE

Director Healthcare Initiatives ACI Boland Architects

Healthcare is in the midst of an era of changes, where maintaining the status quo is not acceptable. One noticeable trend is how to manage patients through the continuum of care in an integrated manner? Lessons can be learned from our Critical Access Hospital leaders, which can use swing beds to provide one level of post-acute care integration.  A 2012 research study of 310,000 Medicare discharged patients by RTI International and Cain Brothers, found that almost 80% of the discharges received some form of care in a Post-Acute care setting, which is not all that surprising. However what is surprising was of the 80%, 21% received care in 2 Post-Acute care settings, and 4.2% received care in 3 acute care settings.

The same sample study also noted that 23% of Medicare patients sent to a Post-Acute setting was readmitted to the hospital. The study did not indicate the readmission rate for the patient population that received care in 3 or more Post-Acute care settings. My experiences would tell me a high portion of the 4.2% that received care in 3 or more Post-Acute care settings, had higher rates of hospital readmissions. Certainly an opportunity exists to track these patients to proactively manage their care.

As we migrate from a volume driven to value driven system, this is an area of improvement among all the Acute Care and Post-Acute care providers. For the most part, these two segments of the healthcare industry have been operating within each of their borders. The challenge is to how integrate these two segments to provide the holy grail of the continuum of care that provides the best care for the patient? Perhaps the safe first step is the “walk before you run strategy” by starting with communication, then collaboration, and perhaps a joint venture if appropriate.

Starting a communication forum with Post-Acute care providers will provide ample opportunities for discovery and perhaps identify quick and easy steps for improvements. Collaboration in creating clinical protocols and discharge planning as a team could result in less stressful transition for the patient across the healthcare delivery system. Perhaps a joint venture with Post-Acute providers’ creates opportunities for an even higher level of integration.

My interest in this topic has evolved from being the Treasure of a not-for-profit skilled nursing home for several years now. I have experienced where opportunities exist for acute care and post-acute care providers to team up to provide the best for “our patient”. If you have an interest in this topic our chapter is providing a face to face panel discussion August 16th on this topic. We would encourage you to attend and would seek your participation in the discussion to share your perspectives as we are all breaking new grounds on this front.          

Rod Corn FACHE

Director Healthcare Initiatives

ACI Boland Architects  

Pomeranz, R., Ritchie W., (Summer 2012, Volume 71), Integrating Acute and Post-Acute Care: The Emerging of the Sectors. Strategies for Health Care Leaders. Cain Brothers