Treatment for Acute Health care in the 21st Century

When someone needs help or extra services after a hospital termination, there is a reason as to why a patient is discharged to home, inpatient rehabilitation facility, or long-term acute care hospital. It may be a choice based on convenience to the patient’s home, what the patient is familiar with, or just the hospital discharge planner’s or other clinician’s preferences.

Acute care is often split from the rest of the health care system, which can result in poor coordination of care, higher than normal re-admission rates, and finest patient outcomes. One-in-five patients are admitted to acute care after being discharged from the hospital (about 7.8 million patients annually). On average, 23 percent of patients end up back at the hospital within a one month. Moreover, in acute care services 73 percent of Medicare spending variation.

For years, there was often no real incentive for hospitals to direct patients to the highest quality, most appropriate acute care facility, coordinate care, or continue to track the patient. Some hospitals have a financial reason to care about what happens to their patients after leaving the hospital and should be paying close attention to the acute care.

Our conversations with key acute care stakeholders revealed that there is great potential for innovation in acute care. Directing patients to receive care at home with an aid or to a high-quality acute care facility, for either a short, intentional visit at a lower cost setting than the hospital or for a longer-term rehabilitation stay, could improve patient outcomes and reduce costs. The key is figuring out how a health system responsible for the outcomes of a patient can steer that patient to the best option for them.

Sightsaw of two different ways of health systems which can work with acute care backers.

• Individual: For health systems is to buy or build acute care services. By owning, health systems can control the quality of care for their patients, integrate the information from electronic health record (EHR) systems, and better manage care from a population health perspective. This, however, may not make sense for many health systems. Additionally, many acute care facilities which have very narrow margins or are not performing well. This may pose a risk to well-established, large health systems.
• Acquaintance: Relationships can take different forms, such as joint ventures, leasing beds, and/or preferred referral networks. This could mean identifying the high performers with quality care, patient satisfaction, and low readmissions and developing relationships with them that encourage accountability and high-quality outcomes. Many established partnerships use their relationship as a platform to focus on quality initiatives for acute care.

While building the systems to capture this data may take time and the industry is just in the first stage of reconfiguring acute care, some of the aspirants said that even small, simple changes such as getting the health systems on the phone with the admitting acute care facility to discuss what the patient needs in the next two to 12 hours have huge potential for improving quality and keeping patients from being readmitted to the hospital.

In the current environment, financial incentives often are cock-eyed, cost controls can be inadequate, and outcomes and patient experience can suffer. But we are moving to a new world of value-based care, and under new payment models health systems may need to take a hard look at their post-acute care strategies. That’s a challenge before all stakeholders – how to construct the necessary bridges and communication networks from the disparate health care islands. Patients depend on guidance from their doctors, hospitals, and health plans to make the right choices in a process that can be lengthy and frustrating. Health systems may need to be better at drafting horizontal networks that don’t leave patients and each other stuck on their own island.