Home Health Care In advance of new federal rule, startups vie to steer post-acute care...

In advance of new federal rule, startups vie to steer post-acute care decisions


Tech firms are jostling to help hospitals and health systems comply with federal rules covering patient transitions to nursing homes, rehab centers and other forms of post-acute care.

The rules, which take effect Nov. 29, require hospitals to beef up the information they provide to patients on their options for post-acute care and to document the process, including the recording of patient choices.

“It’s bringing a lot more structure, rules and requirements, I would say, to the way hospitals are presenting options and discharging patients to post-acute care,” said Ryan Miller, co-founder and COO of Repisodic, a Philadelphia-based startup that is among the companies vying to provide solutions. Others include Boston-based CarePort Health and Omaha, Nebraska-based Ensocare, a subsidiary of healthcare management services firm CQuence Health Group.

The rules were finalized in late September by the Centers for Medicare and Medicaid Services under a 2014 law known as the Improving Medicare Post-Acute Care Transformation Act, or Impact Act. They call on hospitals and health systems to provide patients with data on post-acute care choices that match their needs and preferences and to disclose performance data on those choices. The rules also ask hospitals to identify which post-acute care providers are in their preferred provider networks.

“By demystifying the discharge planning process, we are improving care coordination and making the system work better for patients.” CMS Administrator Seema Verma said in a press release issued in September. “Patients will now no longer be an afterthought; they’ll be in the driver’s seat, playing an active role in their care transitions to ensure seamless coordination of care.”

Tech companies have been working to digitize the process, one that they said has been dominated by paper lists and inconsistent workflows that risk putting hospitals out of compliance.

“For various reasons, discharge planning and case management has not been an area of investment in technology for health systems,” Miller said in a phone interview. He and a partner, Mike Cwalinski Jr., founded Repisodic about two years ago after kicking around ideas for a healthcare-related startup. They settled on post-acute care planning after bad experiences with family members.

Repisodic offers a browser-based system that has been live since 2017. Discharge planners and case managers enter information about a patient and the system, called Repisodic Choice, generates an electronic list of post-acute options to share with the patient. The list can be accessed via smartphone, tablet or computer.

The system also can be integrated into a hospital’s electronic medical record system and pull information from there to generate a list, Miller said.

In addition to hospitals and health systems, the company works with providers of post-acute care to manage the information available about them on the Repisodic platform and to manage subsequent transitions for patients, say from a nursing facility to home healthcare.

The goal of tech firms is to make the process simple for discharge planners and avoid disruption.

“Workflow change can be difficult,” Sara Radkiewicz, head of product for CarePort Health, a subsidiary of Allscripts, said in a phone interview.

The company offers a product known as CarePort Guide as a standalone or as part of CarePort Care Management, another product focused on post-acute care. Both are compatible with all electronic health record systems. But since early November, the guide has been available in the Epic App Orchard, a kind of app store for Epic-compatible products. That allows providers to use CarePort Guide inside the electronic record, Radkiewicz said.

The next step is to automatically record in Epic the patient’s selection of a post-acute care provider, Radkiewicz said. Currently, the choice is recorded in CarePort Guide and then manually entered in Epic.

CarePort also is testing a product to generate and send referrals to post-acute-care providers all within Epic, rather than having to switch to CarePort Care Management to make the referral, Radkiewicz said.

Ensocare, meanwhile, has taken a tablet-based approach. Its product, Ensocare Choice, lists options for patients but also allows post-acute care providers to enrich what patients see. In addition to the required performance and other data under the new rules, post-acute care providers can upload virtual tours and other information about their facilities.

“It’s a great opportunity to put your best foot forward,” Mary Kay Thalken, chief clinical officer for Ensocare, said in a phone interview.

Developed about four years ago, Ensocare Choice is part of an older product called Ensocare Transition that speeds up the referral process for post-acute care, Thalken said.

Hospitals have been ramping up their usage of Ensocare Choice as the deadline looms for complying with the new Impact Act rules.

“It’s moving from that paper or manual workflow to digital technology, which obviously is much more appealing to today’s consumer but also a better workflow for the social workers and case managers,” Thalken said.

Photo: mathisworks, Getty Images



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