Senior Director Case Management, West Region
Kindred Healthcare, Hospital Division

Entitlement reform is a hot topic in this election season and no matter your political position or ideas about it, for post-acute providers this brings to light the issue of payment models and the question of how long the current volume-based payment system (the current revenue model) will continue.

Entitlement reform may fail, in which case the existing fee-for-service systems will continue. It may be enacted, with implementation expected over the next decade, but with reforms for post-acute care beginning as early as five years post-enactment. Either way, payment pressures will continue; pay-for-performance and value-based purchasing models will likely be implemented; private payers will continue to move toward integrated care and integrated payment models; and single site providers will be at the greatest risk while non-institutional providers such as home care will be favored.

 Kindred's post acute case management model reflects and follows the expanded standards put forth by the Case Management Society of America (CMSA), explained further in the graphic on the right. The CMSA is an international nonprofit professional organization that supports and advances the case management profession. Source: Case Management Society of America Kindred's post acute case management model reflects and follows the expanded standards put forth by the Case Management Society of America (CMSA), explained further in the graphic on the right. The CMSA is an international nonprofit professional organization that supports and advances the case management profession. Source: Case Management Society of America

Kindred’s mission to “continue the care” for our patients, transitioning them from acute care hospitals to our long-term acute care hospitals, sub-acute units, inpatient rehabilitation hospitals, skilled nursing facilities and homecare and hospice services, uniquely positions us to assimilate to this changing healthcare landscape. Incentives will likely be given for preventing re-admissions to acute care hospitals, and one way to reduce readmissions is by coordinating and successfully transitioning care between facilities and making use of interdisciplinary teams of caregivers.

Communication, education, and higher engagement with the patient and family will be the most important keys to this transition-of-care process. In addition, a shared accountability between providers and organizations will be critical to streamline processes and to do what is best for the patient at all times in patient-centered care.

Our over 500 nurses and social workers serving as Kindred case managers are on the front lines of ensuring interdisciplinary care coordination and successful transitions between facilities. Discharge planning can be complex and patients and family advocates have many kinds of medical and emotional needs that need to be carefully considered at all times. Case managers must deftly negotiate all of these factors, and recruiting and retaining competency and excellence in this role is a top priority. We must place extra emphasis on the growth and development of our case managers, as they play an even more important role than ever in managing patients as they move through the continuum.

Also, partnerships with hospitals and health systems, like the one we have established with the Cleveland Clinic, will likewise continue to play an important role as the healthcare landscape evolves. Kindred and the Cleveland Clinic established a collaborative in 2009 that includes information-sharing initiatives, a care transition focus to identify preventable returns to acute care; physician engagement programs in which Cleveland Clinic physicians provide physician coverage at the long-term acute care and the sub-acute levels; and the development of quality and outcome measurement methodology.

Kindred's post acute case management model reflects and follows the expanded standards put forth by the Case Management Society of America (CMSA), explained further in the graphic on the right. The CMSA is an international nonprofit professional organization that supports and advances the case management profession.

Through these types of partnerships, and with well-trained and skilled case managers at the front lines, we will be equipped to make the most of this new era, continuing to make it our mission to promote healing, provide hope, preserve dignity and produce value for each patient, resident, family member, customer, employee and shareholder we serve.

Kindred's post acute case management model reflects and follows the expanded standards put forth by the Case Management Society of America (CMSA), explained further in the graphic on the right. The CMSA is an international nonprofit professional organization that supports and advances the case management profession. Source: Case Management Society of America

Kindred's post acute case management model reflects and follows the expanded standards put forth by the Case Management Society of America (CMSA), explained further in the graphic on the right. The CMSA is an international nonprofit professional organization that supports and advances the case management profession.