This article is sponsored by Sound Physicians. In this interview, Skilled Nursing News sits down with Dr. Thomas Kim, Chief Medical Officer, Sound Long-Term Care Management, to talk about the importance of long-term care accountable care organizations (ACOs) and their benefits to long-term care patients. He breaks down the care model for Sound’s ACO and explains how they support participating physicians to achieve better outcomes. He also discusses telemedicine’s role as participation in ACOs spreads across the industry.
Skilled Nursing News: What life and career experiences do you most draw from in your role today?
Dr. Tom Kim: As a physician, I’ve spent a good amount of time talking with family members and patients about the transition into long-term care. Having those conversations and getting feedback from patients and their family members about long-term care facilities has been influential. On a personal level, I went through a similar experience with my grandmother, who is currently residing in a long-term care facility for cognitive impairment, so I understand the journey.
The other life experience that resonates with this transition is becoming a parent for the first time. When you have your first child and need to plan for daycare you go through a similar experience of finding someone you can trust to look after your loved one. I think both of those experiences have been influential in my role today, and they have given me more clarity in the work I do.
What is an accountable care organization (ACO) and how do ACOs help the patients involved?
ACOs bring healthcare providers together to drive quality of care and improve outcomes while lowering the cost for patients.
ACOs help by facilitating the coordination of care between multiple care team members such as primary care physicians, consultants, nurses, and ancillary healthcare providers. ACOs also can provide additional resources and data to improve quality of care that individual provider groups may not have access to on their own.
Why did Sound Physicians start an ACO focused on long-term care patients?
Sound Physicians has historically been known as a physician practice of hospitalists, emergency medicine clinicians, critical care clinicians, and now clinical teams for anesthesia and telemedicine. But in the past several years, we’ve focused heavily on value-based care.
We were one of the largest physician groups to participate in Bundled Payments for Care Improvement Advanced (BPCIA). We took lessons learned from our value-based care experience, especially BPCIA, and wanted to develop a care model for a population that we identified to be in need — long-term care facility residents. They’re a population oftentimes overlooked by current value-based programs, but they also have the greatest needs. In addition to the residents, we acknowledged that the nursing facilities themselves were left out of many value-based care programs.
Explain the care model for Sound’s ACO.
When we came up with a care model for our ACO, we knew it had to be simple. The last thing we wanted to do was to put additional burdens on physicians, nurse practitioners, physician assistants, and nursing facilities. The mainstay of our ACO care model is to literally deliver care by bringing care to patients where they are. We provide resources and tools to treat residents of long-term care facilities in place when appropriate. By doing so, we minimize the disruptions to quality of life for the residents and their families.
How does Sound support its ACO’s participating physician groups and facilities to achieve better patient outcomes?
We strive to make it easier for clinicians and facilities to provide better care for their residents without directing the care. One of the ways we do that is by bringing data to the folks who need it most. It’s about clinicians and nurses having actionable information at their fingertips rather than having to look through multiple sources to find information. We also use this data to identify those with the greatest health risks so that they may have additional care management and advanced care planning.
It’s also extremely disruptive for a long-term care resident to have to leave their facility to go to the emergency department or hospital. This can lead to further destabilization of chronic conditions and increased morbidity. So, we advocate for a proactive rather than a reactive approach to care to mitigate escalations of care out of the facility. We also deploy our telemedicine team to evaluate and treat residents where they are. However, there are times when escalations of care are needed, so we also facilitate coordination of care between the care team members, the residents, and their families during the transitions.
We also want to level the playing field. Whether you’re a small or a large provider group or facility, everyone in our ACO benefits from the tools and resources of the ACO, which include data, technology, telemedicine, and care coordination.
What role can telemedicine play in an ACO?
Telemedicine is important for many reasons. It allows the primary care providers to focus on delivering care during the day when most of the vital care coordination and decisions are made. By having our telemedicine physician on-call at night, providers have more time to converse with patients, family members, and nursing staff.
Telemedicine also allows us to respond quickly to resident and nursing needs. Our telemedicine physicians are available at the literal touch of a button to support nurses with any questions or concerns regarding a resident. The telemedicine physician has access to the EMR and can evaluate residents on video to formulate a detailed care plan founded on the principle of treating the resident in place when appropriate. Our telemedicine team has been able to treat in place 96 percent of the time. When residents need higher levels of care, our telemedicine team can provide a warm handoff to the emergency department and 39 percent of the time, accept the resident back to the facility without a hospitalization by ensuring timely follow-up.
Finish this sentence: “The skilled nursing industry in 2024 will be the year of…”
… innovation.
The last thing healthcare providers and nursing staff need is more work. Our population is aging and there will be a greater demand for long-term care. In addition, the supply of healthcare providers and nursing staff is not increasing at the same rate. To continue providing high-quality care and decrease costs, we have to innovate and create efficiency. We will need strategies to incorporate remote patient monitoring, artificial intelligence, and machine learning into our current workflows. We will also need to more widely adopt telemedicine utilization in all long-term care settings.
Editor’s Note: This interview has been edited for length and clarity.
Sound Physician’s accountable care organization (ACO) is a Medicare Shared Savings Program (MSSP) focused exclusively on Medicare beneficiaries living in long-term care and assisted living facilities. With strong, dedicated physician leadership and deep roots in value-based care, Sound’s ACO is committed to bringing better quality of care and satisfaction to the patients we serve. And we’re focused on bringing better financial performance through deep investments in our people, partners, and technology — including telemedicine as a key component to connect patients with the care they need. Our participating physicians, practitioners, and operators earn shared savings of up to 25 percent with no downside risk. To learn more, visit https://soundphysicians.com/specialties/long-term-care-management-aco/
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].