Bridging the Gap: How to manage your ACO’s skilled nursing network

The Department of Health and Human Services (HHS) set the explicit goal of linking 90% of traditional Medicare payments to quality or value by 2018 through alternative payment models (APMs), the Hospital Value-Based Purchasing Program and the Hospital Readmissions Reduction Program.

Data is king. While this is no surprise to accountable care organizations (ACOs), their skilled nursing partners are not as “data conversant”. Yet, using data to manage the care of a population is critical. So how do you, as an ACO, determine which skilled nursing facilities are top performers? How do you ensure collaboration between nurse navigators and the clinical teams in nursing facilities, while keeping one eye on cost of care?

In this presentation, we will take a deeper look into how to assess the skilled nursing providers in your service area, partner with them, and stay connected.

Attendees will learn:

Learn how to determine which skilled nursing providers are top performers
Understand how to develop strong relationships with skilled nursing providers to more effectively manage your population.
Learn how effective communication with skilled nursing providers can reduce hospital readmissions, lengths of stays and cost of care.

About the Presenter:

Phyllis Wojtusik, Executive Vice President at Real Time Medical Systems

Phyllis has thirty-five years of health care experience in acute care, ambulatory care and post- acute care. She has led development of post-acute networks, participated in a Medicare Shared Savings Program (MMSP), and other value-based contract programs. She has also served in physician practice management roles.

Prior to joining Real Time Medical Systems, Phyllis led the development of a preferred provider SNF network for PENN Medicine Lancaster General Health. In this network she developed and implemented strategies that reduced total cost of care and readmissions while improving patient outcomes. She utilized system approaches, clinical standards and care management tactics to improve coordination and transition of care, while reducing post-acute length of stay in a network of non-owned SNFs.

Phyllis also has experience in the physician practice management industry having worked for more than 15 years in a leadership role for a large successful geriatric practice. The practice expanded from two physician providers to more than 30 physicians and CRNPs under her leadership. She also led the development and coordination of a Geriatric Assessment program that focused on dementia diagnosis, treatment and management.

Phyllis’ clinical background includes spending 12 years in critical care as a nurse, nurse manger and case manager. Phyllis speaks nationally and regionally on transitions of care, care coordination and post-acute network development and management. Phyllis graduated from Lancaster General School of Nursing and Franklin and Marshal College with degrees in nursing and science.