Jeffrey Hay, MD
The post-acute care sector faces a rocky future—and significant opportunities for early change adapters—due to a perfect storm of burgeoning costs, dwindling reimbursements, and a growing demand for measurable quality of care. Today, post-acute care providers and payors in some markets still may not see a financial reason to use a coordinated care model for population management.
However, the healthcare system continues to evolve post-Affordable Care Act. In two to five years, there will be a major incentive to employ population management because it offers the means to reap a triple win for providers, payors, and patients:
Now is the time to act because change takes time. In addition, healthcare operators that don’t get in on the ground level will find it difficult to later displace those operators that take advantage of early opportunities, gain experience with a coordinated care model, and lock up referrals in contracts.
In this paper, you will get:
We were successful with the care model described here under Medicare Advantage (MA) and commercial HMO contracts, prior to the rise of Accountable Care Organizations. As a result, what you will see here applies broadly to markets with and without ACOs.