4/22/2018. Redesign and Reimage Long Term Care for the Future. Health Care Landscape Change. Disclosure of Commercial Interests

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1 Redesign and Reimage Long Term Care for the Future Lisa Thomson Chief Strategy and Marketing Officer Disclosure of Commercial Interests We consult for the following organization: Pathway Health Lisa Thomson, Chief Strategy and Marketing Officer Sue LaGrange, Director or Education Pathway Health is a professional management and consulting organization serving clients in the long-term and post-acute care industry. Health Care Landscape Change 1

2 Macro Level - Change Continuum of Care 2

3 Continuum of Care Acuity Clinical Capacity Quicker, Sicker, Faster ALOS Clinical Competency Clinical Integration Partnership, Networks, Payers Legislative and Regulatory 3

4 Legislative and Regulations Affordable Care Act IMPACT Act Protecting Access to Medicare Act (PAMA) Value-Based Purchasing (VBP) Quality Reporting Program (QRP) Requirements of Participation National Quality Strategy Medicaid Reform ROP/COP Skilled Nursing Home Care Inpatient Rehabilitation Facilities Acute Care (IPPS) Quality Expectations 4

5 Quality Measurement SNFVBP SNFQRP NQF RoP CASPER 5 Star Quality Measure Numerous Readmission Measures SNFRM SNFPPR SNFQRP(RM) SNFQM (Short Stay Readmission and ED) Five Star Common Threads from CMS Link payment, referrals and quality Providers accountable for outcomes & costs Episodes of Care Discharges Partnerships, Networks, Systems Transitions of care Clinical Paths/Systems Hospitalizations Medication Reconciliation Adverse events and HAC/HAI Person centered care Resources with patient needs Disease State Management Chronic Diseases 5

6 Organization Data The Link ALOS Readmission Disease State Quality Measures DC to Community Alignment with Partners Data = Quality! QM and Financial Impact 6

7 VBP and Payment Models 7

8 Payment Model Expectations Performance based pay Data, Data, Data Quality metrics New Performance Measures Standardization of data Risk Arrangements Publicly Reported Data New Consumer New Consumer Satisfaction Needs and expectations New care delivery Access to information Data Choices Health plan Provider Physician Services Patient/Consumer centric Partner integrated customer engagement strategy the future! 8

9 New Consumer Seeking Value Moving towards transactional sale Look trough a different lens Empathy and Perception Empathy: The Human Connection Source: Cleveland Clinic Workforce 9

10 Workforce Challenges Work force shortage Recruitment and Retention Workforce Challenges Multi generations Communication Strategies Competency Expectations SME PAC Leadership and Success 10

11 Strategic Relationships Organization Data Strategy Readiness for Change Operations and Clinical Realign and Redesign Market vs. Medicine: America's Epic Fight for Better, Affordable Healthcare David W. Johnson Change is the Norm Efficiency and Effectiveness New Competitors Targeted Solutions Reach new markets Collaboration Differentiation 11

12 Business Model Segmentation Assess Standardize care protocols Review and reduce performance variations True operating costs Preparation for Value based care Play to strengths Strategic Visioning It does not represent legal advice nor relied upon as supporting documentation or advice with CMS or other regulatory entities. 12

13 Leading Through Change Understand Vision Communication Collaboration Outcomes Innovate and Create Innovation Foundation Engage technology Leverage brain power within Invest in leadership Clinical leader redesign Redeployment of workforce Redesign work flows Its not just PPD s 13

14 Innovation Thoughts APM adoption a must! Disease state niche Customer care model Reconceptualize the customer Integrated Care Models Chronic Care Management Model Comfort and Recovery Suites Admission Suites Change is the law of life and those who look only to the past or present are certain to miss the future John F. Kennedy Be the Change! Redesign and Reimage Long Term Care for the Future Lisa Thomson Chief Strategy and Marketing Officer 14