Innovative Care Models Catching Opportunity
Adam Brooks, PT Director of Accountable Care
BAYADA Home Health Care
About BAYADA
Privately owned since 1975 9 specialty service Lines 330 offices 100,000 clients per year 22 states; 6 countries Turning Non-Profit in Jan. 2019
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Shift from Volume to Value – Triple Aim Hospitals
ACO’s
SNFs
Physicians
Total Cost of Care Bundled Payments
Readmissions
ED Visits *
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Networks- How to Find/Participate?
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CMS.gov
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Networks- How to Find Out/Participate?
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Networks- How to Find Out/Participate?
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Data and Outcome Driven Partnerships
Value – Organizations are looking for a combination of performance with lower cost 9
Market Awareness What ACO’s are present in your marketplace? What type of ACO? Downside risk? What Bundles are active? BPCI-A commenced 10/1/18 Are Post-Acute networks forming? Recalibrating? What providers are engaged? Health Systems are seeking creative, innovative ideas that reduce spending and improve outcomes and patient experience. 10
Meredith Mills, MHA, PCHA Sr. Vice President & Chief Operating Officer
Country Meadows Retirement Communities
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Who we are 12 Personal Care/ IL Locations in PA and MD 2,600 residents 100% family owned
Form our own Post-Acute Network Narrow partnerships and create preferred therapy and home health relationships across all sites Use CMS data and metrics to select best quality Start our own hospice
RESULT Consistency in resident experience across all locations Additional clinical support, training, and tools– better able to care for more complex residents Medicare outcomes data that we can share with acute partners and insurers
Offer a drastically reduced rate for short-term, transitional stays in our restorative level of care– exclusively to patients leaving a Hospital, IRF or SNF setting RESULT Intentionally not self-serving: Honors senior’s wish to ‘go home’ Introduces unacquainted prospects to our setting Assists discharge planners struggling with placement 250+ patients referred YTD 54% conversion rate to long term, permanent resident status. Referrals from Medical Professionals represent only 11% of our prospect inquiries, but convert at a rate of 25% to a permanent resident move in
Insurers considering paying us a bundled per diem payment to cover: Therapy Home Health And a Progressions Stay
Sarah Walmsley, PT National Director of Strategic Partnerships – Senior Living Solutions
BAYADA Home Health Care
BAYADA Senior Living Solutions LAUNCHED IN 2012
Health Services Provided
Home Health, Outpatient Rehab, Welln Fitness and Hospice
5,000
1,200
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Residents currently under BAYADA Senior Living Care
Communities across the US
States where BAYADA Offers the full suite of services Soon to be 16
Conventional Network
HOSPITAL
SNF
Innovative Network ASSISTED LIVING
HOSPITAL
Rehab / Respite Model Hospital has agreed to rent 2 rooms an AL to house patients that are driving up internal costs.
ASSISTED LIVING
Win Win Win . . . HOSPITAL
Home Health nursing and therapy support Medical and Rehab needs
Home Health / Rehab Agency
From Theory to Reality
Identify Pain Points
Quantify Costs
Integrate AL Partner
Build the Solution
Engage Stakeholder s
Contract
Financial Savings SNF
ASSISTED LIVING
HOSPITAL
~1,500 / Day
$365 / Day
$200 - $250 / Day
Using AL, forgoing SNF, total cost savings - $26 k/ patient over the 6 months
Lessons Learned Identify the Decision Makers
Present a Developed Solution to Customize
Work with Established Partners
Prepare the Legal Team
“Patience is a virtue and I’m learning patience. It’s a tough ― Elon Musk
Decision Makers How to gain the meeting
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Social Workers
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Director of Population Health
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Vice President of Clinical Innovation
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Chief Financial Officer
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Chief Executive Officer