The extent of a hospital’s reach is changing. As the industry shifts towards value-based care, hospitals and health systems must think beyond its walls and work to coordinate care across the continuum, so patients can smoothly transition to the next care setting—until they ultimately return to wellness.
Until now, care coordination has been an incredibly inefficient process. Although most hospitals are adept at managing care within their organizations, it becomes more difficult when looking past the hospital setting. The problem is hospitals don’t have consistent and reliable methods for communicating with post-acute facilities and monitoring patient care. This is especially troubling because hospitals are being asked to take on more financial responsibility for patient outcomes after patients are discharged. Programs like the Comprehensive Joint Replacement (CJR) initiative from the Centers for Medicare & Medicaid Services (CMS) now require hospitals to coordinate care, signaling CMS is comfortable making these organizations the center of gravity for patient outcomes.