Post-Acute Care Integration
Care providers know better than anyone how important it is for patients to receive the right care at the right time, especially after leaving an acute care facility. Not only does post-acute care help reduce hospital admissions, readmissions, and bed days, but it also has the power to improve the care experience, health outcomes, and patient satisfaction.1
The goal is to help care providers receive approvals faster, so they can discharge patients to post-acute care sooner. That can help hospitals manage inpatient census, support better health outcomes, and deliver better value.2
We're Tackling Post-Acute Wait Times
The average length of stay pre-discharge is about one day longer than it was in 2019.3 That's a problem because more unnecessary hospital days means patients have a higher risk of developing hospital-acquired complications and higher costs.2 We're working on solutions to help reverse the trend.
Collaborating to Streamline Authorizations
The macro- and micro-factors driving up post-acute care wait times range from staffing shortages to demand increases. For our part, we're tackling prior authorization delays.
Our real-time provider portal reduces delays by automating much of the approval process. The system asks care providers to identify core administrative information and answer questions about their patients.
The portal presents an opportunity for us and our care provider partners to make a huge impact for patients. By reducing wait times, we can decrease the number of days patients spend in a care setting that's no longer best suited for their needs, making the patient journey more efficient and effective.
We're monitoring metrics such as readmissions and ER visits to see how impactful the portal has been for patients and care providers. With the program rolled out across our Medicare markets, we've seen positive outcomes in consumer satisfaction, care provider engagement, and affordability, as well as improved financial results.4
We plan to extend this partnership throughout 2024 to cover durable medical equipment needs and wound care, as well as to close gaps in care to improve our overall performance with respect to the Centers for Medicare & Medicaid Services Five-Star Quality Rating System.
75%+
of our Medicare care provider partners use the automated portal5
1.8 days
average time it takes to close a case6
23%
reduction in average length of stay for skilled nursing facilities supported by the portal in 20237
68%
of care providers agree initial authorizations are easy to obtain, compared to the previous process8
Driving Value to Improve Outcomes
Improving the patient discharge experience is especially impactful when we consider how it could help advance the healthcare payment landscape.
Post-acute care is essential to retaining the value and impact of acute care. By more tightly integrating the two, the care providers who use our portal can improve patients' whole health. That opens the door for value-based care arrangements, which we know help improve outcomes, advance health equity, and lower healthcare costs.9
1 Yu-Chun Wang, Ming-Yueh Chou, Chih-Kuang Liang, Li-Ning Peng, Liang-Kung Chen, and Ching-Hui Loh: Post-Acute Care as a Key Component in a Healthcare System for Older Adults. Annals of Geriatric Medicine and Research (June 2019): ncbi.nlm.nih.gov/pmc/articles/PMC7387590/. 2 Kelley Tipton, M.P.H., Brian F. Leas, M.S., M.A., Nikhil K. Mull, M.D., Shazia M. Siddique, M.D., M.S.H.P., S. Ryan Greysen, M.D., M.H.S., Meghan B. Lane-Fall, M.D., M.S.H., et al.: Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (September 2021): ncbi.nlm.nih.gov/books/NBK574435/#:~:text=The%20reviews%20described%20eight%20strategies,%3B%20hospitalist%20services%3B%20and%20telehealth. 3 CarePort Health: The Evolution of Care: An Annual Care Delivery Report (accessed October 2023): careporthealth.com. 4 Carelon, post-acute care institutional management program analysis (December 2023). 5 Carelon, internal data (December 2023). 6 Carelon, internal data (December 2023). 7 Carelon, post-acute care data analytics (December 2023). 8 Carelon, internal analysis (2022). 9 The Commonwealth Fund: Promoting Health Equity by Changing How We Pay for Care (Aug 15, 2023): commonwealthfund.org.