INDUSTRY INSIGHTS | WINTER 2011/2012 EFFECT

Seven Resolutions for Aging-Services Providers in 2012

by Andy Edeburn

The year 2011 is almost gone, and for those in the aging-services field, it’s been an interesting ride. From the state budget challenges and reimbursement cuts to declining occupancy and the whirlwind of health care reform—we can only wonder what the next 12 months will have in store. In order to help us navigate the changes, here are seven actions that providers can take in the coming year to keep on top of the changing industry.

1. Health reform is here—figure out where you fit in.

While some aspects of federal and state reform may be tested by the courts and Congress, its core elements are here to stay. The financial and demographic factors—like Medicare insolvency and aging Baby Boomers—are simply unavoidable.

However, with new changes come new opportunities. Take this chance to explore what’s new and forge a new path for your organization. For instance, you can learn more about value-based payment (VBP) or accountable care organizations (ACOs). Problems need solutions, and we can help create them—but only if we embrace the changes ahead of us.

2. Read your mission statement aloud.

Hearing things aloud makes them more real. On the morning of your first day at work in 2012, find your mission statement and read it to yourself and your coworkers.

For many of us, our mission is the root of who we are, how we came to be, and what we do. Reminding yourself of your mission is a great way to focus your attention on the larger picture, rather than getting bogged down in details.

3. Visit your market competitors.

We are often so focused on our business that we lose sight of what our competitors are doing. This can be detrimental, since you can’t know where you stand in a market without comparing yourself to others.

In 2012, make a practice of visiting your competitors and other providers who work with older adults. You’ll probably learn that they have the same challenges as you, but you may also learn the different ways they respond to those issues. You might discover opportunities to work together. At the very least, you will have established or strengthened a relationship, which is key in the evolving health care environment.

4. Develop a learning collaborative.

If you read any trade publications or attend any conferences, you’ll encounter a wide range of new ideas about models of care, payment reform, and health information technology and integration. It’s nearly impossible to know and understand everything on your own, so form a “learning collaborative.”

Bring together members of your own organization and other like-minded providers to study and share new ideas. Approach it as a book club for senior living providers. Pick one topic a month and discuss it, or find another industry professional to facilitate a discussion.

5. Learn more about evidence-based medicine.

Evidence-based medicine relies on established methods or practices of care grounded in research. This is a significant change because a lot of today’s health care services evolved from opinion or subjective interpretation. Those in the industry generally agree that applying evidence-based practices results in better patient outcomes and reduces the cost of care.

For aging services, this is an exciting and expanding area. Interventions to Reduce Acute Care Transfers (INTERACT), State Action on Avoidable Rehospitalizations (STAAR), and Care Transitions are just three examples of programs with measurable outcomes for both patients and providers. Implementing these kinds of initiatives is feasible for many providers.

6. Learn about operational costs for each patient, and prepare for bundled payments.

As providers, some of you may have never really thought about total cost of care for individual patients. You understand the revenue side, and can probably speculate about a rough cost, but do you really know how much it costs to care for an 82 year-old who needs a hip replacement? If you don’t, you need to—because that’s going to determine your share of a bundled payment in the future.

Bundled payment is likely to become the preferred payment vehicle before the end of this decade. For instance, the Center for Medicare and Medicaid Innovation (CMMI) recently announced its first bundled payment initiative, and there are most likely more to come. While the new payment method is still evolving, a core issue for aging services providers will be cost of patient care for different ailments—from joint replacement and congestive heart failure to pneumonia and stroke. You need to have a comprehensive understanding about the costs of care within your organization.

7. Demonstrate your value.

The meaning of “value” in the health care industry encompasses the intersection of lower cost and improved quality. Into the future, the value of your organization will be based on how well it can accomplish both of these things.

Your value is also intangible, because you understand aging patients’ needs better than many other health care providers. You’re in a position to add value by extending more care into the community. Improving coordination of care with both the customer and other providers after discharge is a great first step.

There are a lot of challenges ahead of us, but there are also a lot of opportunities. Taking proactive measures to embrace change is the first step to keeping your organization viable. Make 2012 a year of focused and thoughtful activity.