Session ID: 
135

Case: Building a Quality-Driven Narrow SNF Network

11:30am - 12:30pm Wednesday, February 13
Orlando - Orange County Convention Center
W315A

Description

CareMount ACO, a physician-owned multi-specialty medical group currently participating as a Medicare Next Generation ACO in the Hudson Valley, explains how they developed and financed a narrow Preferred Provider Network of high-quality skilled nursing facility (SNF), home health and other ancillary providers. The ACO spends ~20% of its $300M in total medical premium on post-acute and ancillary settings, and transient Medicare FFS patients were being discharged to 200 SNFs with high variability in quality, length of stay, cost and readmission rates.  CareMount physicians narrowed the network, negotiating preferential pricing with the highest quality SNFs.  CareMount will explain how to (1) use a Medicare Next Gen ACO contract to finance this network development strategy, (2) run a competitive contracting and bid process, (3) design an incentive payment program and (4) implement the infrastructure required for effective care coordination and quality management across settings.

Learning Objectives: 

  • Employ data to assess the variability in quality and cost for the care provided by your post-acute network
  • Analyze how and why the NextGen ACO payment model offers the financing strategy and opportunity to integrate post-acute care delivery with independent physician groups
  • Plan an RFI-based approach to narrowing your network that is attractive to SNFs
  • Explain why care quality is the most important factor in selecting partner SNFs to contract under the total cost of care
  • Describe the importance of a care coordination program across acute and post-acute settings

Speaker(s): 

Deputy Chief Medical Officer & Chief Medical Value Officer,
Caremount Medical
Executive Director,
Caremount ACO, LLC

Audience: 

C-Suite
Healthcare Financial Professionals
Population Health Management Professional

Level: 

Advanced