Case: Building a Quality-Driven Narrow SNF Network
11:30am - 12:30pmWednesday, February 13
Orlando - Orange County Convention Center
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.