Good evening to all.

As I sit at my cigar club, going through my emails, the questions I am receiving revolve around whether to make or buy the elements to a post-acute care continuum.

The emails ask “Do I want to totally own and operate my post-acute care continuum or can I buy/lease some or all of it??”

There truly isn’t one correct answer.

I am responding to these emails by asking “what is your true objective for your Post-Acute Care Continuum??”

This can be challenging as some C-Suite executives have different objectives. These include; driving better quality outcomes, building a strong ACO, support the acute care side of the house, increasing revenue or all of the above.

The first order of business is gaining a common mental model from executives on what their true objectives (s) are for your post-acute care continuum.

Most post-acute care continuums are made up of these elements:

• Long Term Acute Care Hospitals
• Home Care (skilled and non-skilled)
• Hospice
• Senior Care Communities (Skilled Care, Assisted and Independent Living)

There are several approaches to building your post- acute continuum. Let’s look at a couple of examples.

There is a new company called Evolution Healthcare that contracts with health systems to manage and staff the home care and hospice piece of a post-acute care continuum. They bring an expertise that is outcome driven that some health systems just don’t possess. An interesting and new approach.

Most health system based hospices are undercapitalized both in terms of money and talent to truly deliver all four-levels of expert hospice care.

Tenet Healthcare has a strategic partnership with Seasons Hospice and Palliative Care. Seasons bring to the table an expertise in Inpatient Hospice Unit development that has documented outcomes in reducing Mortality Length of Stays, reducing inappropriate hospital readmissions and maximizing DRG payments.

These examples suggest Health Systems are more open than ever to exploring strategic partnerships as they develop their post-acute care continuum!! This provides hospice and home care companies opportunities to play a significant role.

If you are a health system, what are you doing? If you are a hospice and/or home care company, what is your strategy?