PAC Performance Key to Value-Based Program Success
Kris Gates
Founder @ Preventive Pay | Entrepreneur | Passion for HEALTHcare | Generative AI
If your ACO pulls one analysis this week, make it be the Post-Acute Care (PAC) Summary which summarizes PAC provider performance.
In 90% of cases, PAC provider performance is the root cause of exceeding the target price. Either due to complications, re-admits, emergency visits, expensive daily rates or excessive length of stays.
ACOs are in a unique position in that they get a monthly feed of data to conduct such analysis. Those in the BPCI program get sporadic data feeds. Organizations syncing the weekly Medicare data feeds enabled by Get Your Health Record Mobile App are in the best data position.
In any data scenario above, your team knows in minutes its PAC performance issues. The key is doing something about it. If you are in the 3-day SNF waiver program, you have no choice but to weed out the low performers. The same weeding out low performers methodology should apply to those not in the 3-day SNF waiver program either via an ACO or bundle payment initiative.
We recommend ACOs treat each DRG as a mini-ACO. Those in metro areas can easily achieve the necessary shared savings by focusing only on episode of care performance.
Founder @ Preventive Pay | Entrepreneur | Passion for HEALTHcare | Generative AI
6 年John - Primary recommendation is to remove poor performing SNFs from your network or put a plan of improvement in place with them.? Poor performing SNFs are those with high emergency visits, re-admits or complications.? Next is to review your discharge protocols.? For example, when does a person get sent home vs. home health vs. SNF.? If a person does not need a SNF level of care then home health or home is less expensive alternative.
Company Owner @ J Kelly & Associates LLC | Business Consulting
6 年Kris After you pull the date on PAC, what are the primary recommendations you give to ACO’s to improve financial performance?