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IMPACT ACT

Impact Act Readiness Survey: Findings from 80 Health Systems

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Impact Act Readiness Survey: Findings from 80 Health Systems

Under the Impact Act, new rules have been proposed which will require hospital discharge planners to provide patients with more detailed information about the quality of care and clinical services provided by post-acute care providers. 80 health systems across the US share how their organizations are responding to the proposed changes.

KEY TAKEAWAYS

FROM STRATEGY TO IMPLEMENTATION: THE GOOD, THE BAD, AND THE UGLY

High Awareness of the Impact Act: The vast majority of health systems understand that the Impact Act will require changes to discharge planning workflows, with 85% of respondents reporting awareness of the Impact Act.

Change is on the Horizon: Today 59% of health systems give patients paper lists with names and addresses of post-acute providers. But this is quickly changing under the new legislation and alternative payment models. Healthcare organizations are starting to share post-acute quality and preferred providers with patients.

It’s Top of Mind: Most organizations are preparing to comply with the proposed discharge planning mandates. They are not waiting. 32% of organizations are already supporting these measures and another 46% are planning to implement new workflows within the next 12 months.

Printed Lists with Names and Phone Numbers: 59% of respondents reported that their organizations only provide a printed list of post-acute providers with names and phone numbers.

The Good: It’s easy.

The Bad: It’s generic. The list doesn’t show patients providers that they can actually go to. Many facilities on the list may not accept a patient’s insurance or offer specialized services a patient may need such as Total Parenteral Nutrition.

The Ugly: It’s not compliant. The proposed conditions of participation under the Impact Act specify that discharge planners are required to share information on quality of care and clinical services provided by post-acute care providers.

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Preferred Providers: 39% of respondents said their organizations provide a printed list with preferred providers denoted. One respondent described this as a “list of our owned/affiliated providers on the front page and other providers on the back,” while another respondent described a list organized “by insurance carriers.”

The Good: Patients should be informed about preferred post-acute providers as these hospital partners often have better outcomes.

The Bad: A list with preferred providers “in bold” or “at the top” is not effective. A list is a list. Multiple respondents noted that patients continue to choose based on geography.

The Ugly: A list with preferred providers is a step in the right direction, but it ultimately misses the point. The status quo where patients are not truly engaged and continue making uninformed decisions persists.

Post-Acute Provider Quality: Only 43% of respondents currently provide information to patients about the quality of post-acute providers, and they report that keeping this information up-to-date is challenging. According to one respondent, “our biggest challenge will be compiling quality measures and updating information on post-acute providers.”

The Good: Providing quality information to patients addresses a key component of the Impact Act.

The Bad: Keeping quality information up-to-date on a paper list is difficult. For example, this involves someone tracking quality on an ongoing basis and creating and disseminating a new list to case managers and patients every time a change occurs.

The Ugly: 57% of respondents do not provide patients with any information about quality. Many patients are still making decisions about their post-acute care blindly.

Survey Respondent

“Our biggest challenge will be compiling quality measures and updating information on post-acute providers.”

PAC

SNF

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Post-Acute Provider Clinical Services: 74% of respondents currently provide information to patients about the clinical services of post-acute providers.

The Good: Providing patients with information on clinical services performed by post-acute providers addresses a key component of the Impact Act.

The Bad: This information is difficult to keep updated on a paper list.

The Ugly: 26% of respondents do not provide patients with any information about services, so patients may be choosing clinically inappropriate providers.

Modified Paper Lists: While many health systems still use printed lists with only facility names, addresses and phone numbers, a growing number of organizations are now providing patients with modified paper lists that include quality scores, clinical services, and information about preferred providers.

Limited Impact of Paper: Modified paper lists may follow the letter of the Impact Act law. But they do not follow the spirit, which is to engage patients in choosing higher quality providers where there is a lower likelihood of readmission.

Lessons Already Learned: For health systems that have already started using paper lists, they report that it fails to truly engage patients. Patients continue to primarily choose providers based on geography. Additionally, from an implementation point of view, organizations report difficulty maintaining up-to-date information on post-acute provider quality and clinical services.

Discharge Delays Persist on Paper: Organizations also report that these paper lists do not address critical issues such as discharge delays because these lists do not provide important information such as the post-acute provider’s accepted insurances or pictures.

A Winning Strategy is Emerging: A small but growing percentage of health systems now provide interactive websites and tablets for discharge planners and patients to search for and review post-acute providers. These organizations report benefits such as increased patient satisfaction, reduction in hospital avoidable days, improved post-acute length of stay and readmisssion rates.

THE BOTTOM LINE