Texas-based Touchstone Communities hasn’t been slowing down this year, with the operator busy acquiring and building properties. On top of brick-and-mortar updates, Touchstone also partnered with Longevity Health in January to offer institutional special needs plans (I-SNPs) to its residents.

It’s very thoughtful, controlled growth aimed at diversification of assets, said Leslie Cunningham Campbell, COO for Touchstone.

Coinciding with this growth is a narrowing of partner networks, Campbell told Skilled Nursing News. The Touchstone team has been deliberate in choosing partners because it seems that these days there is more accountability being sought over quality measures (QMs), one that stretches beyond the facility. And so, partners for care transitions have to be chosen wisely, she said.

“Payers do this, hospitals do it – there’s preferred status. If we’re going to be held accountable, both from a quality measure perspective and a reimbursement perspective for what happens outside of our four walls, we better start narrowing our networks,” said Campbell.

Amidst all this flurry of activity, Touchstone also acquired four new communities as of May 1, and in June accepted the first patients for its newly constructed facility in Brownsville, Texas. Also, another newly constructed community is well underway in Montgomery County, near Houston, Texas.

Touchstone’s access to capital for such projects is thanks to its deep relationships and proven ability to generate return on investments, she said.

This conversation has been edited for length and clarity.

What has Touchstone been up to in terms of growth or diversification?

We haven’t been sitting still. I joined Touchstone in 2020 and since that time, we’ve opened a couple of communities. It’s our first entrance into the assisted living space, part of our diversification strategy and our intention to expand our ability to touch the resident or patient across the spectrum of care.

We launched a home health agency, again, part of our deliberate, intentional strategy to increase our reach across the spectrum. This all will drive into value-based care. And then we’re opening another brand new, newly constructed community down in Brownsville, Texas.

We have another newly constructed community well underway in Montgomery County, near Houston, Texas.

We’ve installed dialysis bins in both of them, they would cater to the market needs. We’ll have a diabetes specialty unit at the Brownsville location.

We’ve been very fortunate to have access to capital via deep relationships and proven ability to generate our [return on investments] ROIs. We’ve had locations where we’ve been able to access beds, and in those cases, we’ve just taken the ball and run with it. We opened up a newly constructed community in Penitas, Texas, during the middle of a pandemic, actually.

The main driver around all of this was keeping the airplane in flight, in the normal course of business.

What about changes linked to value-based care and quality measures?

Just in January we launched an I-SNP, we bought into one so we have real, partial ownership in that. It was important for us to have a piece of that rather than to just be a player. All of that is to say that this is really about the paradigm shift. We’ve been managing the business as it is today, and we’ve been thinking about the future, with value-based care.

If you don’t position today what you need to do to be successful, then you really get left behind in the future. The launch of all of those strategic initiatives was along those lines. Part of that strategy also included narrowing our networks. Payers do this, hospitals do it – there’s preferred status. If we’re going to be held accountable, both from a quality measure perspective and a reimbursement perspective for what happens outside of our four walls, we better start narrowing our networks. 

We’ve been very deliberate about doing that, creating our own opportunities, for one thing, but then paring down the number of partners that we do business with, people who have similarity in values, in the way in which they approach care.

So you’ve been more selective with your care partners, hospitals, when it comes to value-based care?

We have begun to think about the care transitions when someone goes to a dialysis appointment, when someone goes to a primary care appointment. Any of those things that can add cost to the system, we want to know how can we facilitate handoffs that result in fewer errors, fewer trips to the hospital?

And then, what’s our value proposition for pre-admission? While we’re not necessarily held accountable for outcomes in that bucket, we most definitely can bring forward a value proposition. Our value proposition quite simply is being partnered with a very strategic partner using AI that allows us to review hundreds of papers, medical records in about 15 minutes based on algorithms that we built versus [spending] the prior three to four hours to get through that entire thing.

This allows us to more swiftly get to reducing hospital time, reducing cost, and then hopefully getting us more volume. But ideally, we want to be the solution. Plus, it frees up time. It frees up time for our nurses to be at the bedside of our patients.

That doesn’t generate us any revenue on the front end, but that’s our value proposition.

Any long-term goals you want to mention?

We are launching a strategic partnership with one dialysis provider. We believe that that gives us some unique differentiation in our markets. We also have launched incrementally this whole approach to care transformation. This gives us resources that we’ve deployed before the resident gets to our community, and then the resource follows the patient after they leave our community.