Welcome to the CEO’s Blog!
We have finally launched our Post-Acute Care Management Services Organization. The team we have brought together have been in the market for quite some time and have a proven record in creating innovative solutions to complex problems. We all believe that there is a need to aggregate the providers in this space and create an opportunity to be fairly paid for the value that is delivered to the Health Care Continuum.
I personally started many years ago in the infancy of the Home Infusion Industry, just about the same time Managed Care 1.0 was developing in Southern California. To say that we all learned how to work together literally by the seat of our pants would be an understatement. First was the hurdle of, “You want to treat my patient at home instead on the hospital”. Then we had the pleasure of telling most patients, “I’m sorry, this is not covered by your insurance company.” We quickly figured out that it made sense for Managed Care Organizations to ‘cover’ this new service as we provided at least as good, if not better, outcomes than the hospital and the cost was usually one fifth that of the acute care facility.
Fast forward Thirty years, and we are still having the same arguments in many parts of the country. We all agree that Health Care Reform is here to stay; we definitely don’t agree on the form but we agree that we can’t sustain the annual increase in cost year over year. As the clinical and financial responsibility is pushed to the local market the need for providers to work together becomes more important. The markets are weaving together Hospital Services with Physician Services in a variety of three letter acronyms. They are beginning to take on risk for the populations they serve (creating Risk Bearing Entities (RBEs)) and building the infrastructure to meet the needs of what I like to call Managed Care 3.0.
One of the fastest growing sectors of the “Managed Care 3.0” market are the Seniors enrolling in Medicare Advantage. This group is also growing in size simply because the Boomer population is aging. Eminence MSO will address this growth by partnering with Senior Living facilities as a corner stone to the Post-Acute Care MSO. We will deliver the ability to move patients from Acute Care settings to Skilled Nursing Facility and ultimately their home. Home could be a traditional house or an Assisted Living Facility, either way their long-term residence. Eminence MSO will provide specially trained Clinicians/Physicians to manage this population and apply the best practices to meet the both the clinical and financial outcomes.
Eminence MSO will align the incentives between the Risk Bearing Entities and the Post-Acute Care providers by creating Value Based Compensation models. As we move patients from the Acute Care setting and reduce the length of stay, we will be compensated beyond a Discounted FFS model. As we prevent Emergency Department visits, we will be paid for that management. Instead of paying $2,000 per day for a patient to sit in hospital or $1000 for a Skilled Nursing Center, we move that patient appropriately through the continuum and share in the savings!
We live by the three “Rights”: Managing the Right Patient, in the Right Location with the Right Care plan while aligning the Incentive by getting fairly compensated for the value we bring to the table!