“Hospital executives are facing a relatively new challenge: managing the financial risk of bundled or capitated payment after a patient is discharged. Now that post–acute care providers are an extension of a hospital’s care-delivery model, their performance has direct implications for the hospital’s reputation and bottom line. Not only must these providers meet threshold cost, quality and patient satisfaction expectations, they must also agree to performance targets and service level standards as well as forge a relationship where transparency, accountability and continuous improvement are the norm.”

Their best practices include:

Strong internal partnerships

“All too often, executives make important decisions about partnership objectives without the right people at the table. Organization leaders need to consider what’s needed from post-acute partners, and this often requires thinking beyond the constraints of current organization charts.

“Because post-acute partnerships balance clinical, operational and financial needs, key stakeholders should include high-volume discharging physicians; population health leaders; and representatives from the finance, care management and legal departments. Before they begin discussions with prospective partners, these stakeholders need to agree on the services and performance commitments they expect partners to provide and on the responsibilities for managing the relationship.”

Shared values and mutual commitment

“Common culture, mission and patient care philosophies are the underpinnings of strong partnerships, but executives can’t readily discern such values from document reviews or brief conversations. They need to spend time with potential partners, observe their operations and processes in action, get feedback from patients and family members, and actively engage leaders and key care staff. ”

Measure what you manage

“The partners should agree on performance commitments and on a performance measurement process that enables all parties to monitor what’s working and what’s not, quickly identify issues, and establish ongoing improvement priorities. The two entities must clearly specify data sharing and reporting protocols. They should also balance metrics for key value domains including efficiency, quality, patient satisfaction and outcomes.”

A partnership’s value should be greater than the sum of its parts

”Hospitals and post-acute providers alike benefit from the synergies of well-managed, collaborative relationships. More progressive hospitals are providing electronic health record access and educational programs to top-tier skilled nursing facility partners, helping them improve the efficiency of their processes while improving clinical staff skills.

”Other organizations hold periodic performance review meetings to share best practices such as standardized care protocols for heart failure patients or identifying patients at high risk of readmission. Hospitals can gain valuable insights about the impact of late-in-the-day discharges, for example, enabling them to make changes benefiting all parties.”