Houston Methodist is streamlining its post-acute strategy by adding extensivists to discharges and making changes to its insurance approach.
The system initially used extensivists in home discharges, and after success in that program, it is expanding their assignments to post-acute care discharges. Extensivists help patients transition to post-acute facilities to improve care continuity and reduce readmissions, Sharon Johnson, vice president of operations at the system, told Becker’s.
Houston Methodist is also tweaking its approach to insurance denials. First, it is involving more families in the insurance denial appeals “as insurers tend to be more receptive to families than to peer-to-peer challenges,” Ms. Johnson said.
The system also is using letters of agreement that streamline the financial approval process. The system partners with frequently used post-acute facilities to guarantee payment for two weeks if an insurance company denies coverage.
“The strategy has been highly effective, with only one denial resulting in a two-week payment obligation,” she said. “This approach expedites the discharge process, freeing up acute care beds without requiring patients to remain inpatient for the additional 48 hours needed for insurance verification.”
The system has maintained five-star ratings for six years and low remission rates, all while prioritizing post-transplant and oncology patients, Ms. Johnson said. It attributes its success to its staff and a staffing model that closely mirrors acute care rather than traditional nursing home staffing.
