Case Management

Strengthen postacute relationships to prepare for healthcare reform

Case Management Monthly, December 1, 2010

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“If your hospital also provides rehab services or skilled nursing, you may want to make sure those relationships are as strong as possible before we move to global payments,” says Beverly Cunningham, MS, RN, vice president of clinical performance improvement at Medical City Dallas Hospital.

With global payments, organizations that received one payment for each of those services (e.g., acute care, rehabilitation, and skilled nursing) will get one payment to distribute among each setting, Cunningham says. Facilities that have employed physicians may also find that suddenly they are the payers to the ED physicians. 

Make sure each of your organization’s settings keeps a data dashboard that captures key measures that apply across the continuum (i.e., readmission rates, cost per case, and quality measures). Your organization should also establish an executive committee to review the information and make improvements to get the most out of global payments. 

“Taking what we know right now about healthcare reform, we need to look at our dashboard and results to find out where we need to improve. Right now when we do strategic planning we are estimating what the market is going to look like. Healthcare reform is no different,” Cunningham says.

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