With Hospitals Taking Cues From Insurance, Post-Acute Providers Need to Stand Out

Acute care providers have begun to take cues from insurance companies as they vet their post-acute partners.

That’s according to a panel of case managers at the Senior Care Marketing Sales Summit (SMASH), held in Rosemont, Ill. Hospitals are penalized for every readmission, and as a result, acute care leaders are paying increasing attention to where patients are going after discharge.

For that reason, post-acute providers are going to have to freshen up their approach to hospital partnerships.


“What I always want to hear from them is: What makes you different?” Jeff Crofoot, manager of inpatient care coordination at the John H. Stroger Jr. Hospital of Cook County in Chicago, said during the Tuesday panel discussion. “It helps a lot when I’m doing the discharge planning. If I know I need a place where a facility is doing dialysis and vents, that’s huge.”

A SNF may not be able to take a particular patient, especially if that person requires specific services. But refusing a patient shouldn’t damage the SNF’s relationship with a hospital, as long as the facility is honest with the hospital case manager, Crofoot added.

Hospital case managers are also making use of various electronic platforms to stay on top of the capabilities of local facilities, according to Colleen Morley, director of case management at West Suburban Medical Center in Oak Park, Ill. She is also president-elect of the Chicago chapter of the Case Management Society of America, while Crofoot serves as secretary.


“If the local facility you’re working with has a solution like that, make sure you’ve got all your profiles up to date,” Morley said. “And if things change, make sure you change that.”

SNFs and post-acute providers also should not overlook the human factor; relationships with local hospitals are crucial, but the methods of building them have changed over the years. Treats are no longer enough for SNFs to forge partnerships with local hospitals, the SMASH panelists agreed.

Even existing measurements aren’t always sufficient. While he does look at metrics like the Centers for Medicare & Medicaid Services (CMS) star ratings, Crofoot said he prefers to dive deeper into the numbers.

“I do also look at things that are further in there, such as minutes of nursing care per patient,” he said. “I would almost prefer that, instead of higher star ratings.”

And as hospitals put together preferred provider networks, they are carefully vetting all of their partners, Morley emphasized.

“The insurance companies have already done that by putting together their networks,” she said. “The acute care facilities are finally getting on board and saying, ‘This is how it should be.’ The insurance companies have already vetted these places, they’ve chosen the best of the best … and now the hospitals are doing the exact same thing.”

Written by Maggie Flynn

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