Harmony Healthcare Blog

AHCA Provider Lounge Series: CJR and Cardiac Bundled Payment Models (video)

Posted by The Harmony Team on Thu, Dec 15, 2016

Edited by Kris Mastrangelo

Interview with Melissa Powell, COO - The Allure Group

Kris Mastrangelo, President of Harmony Healthcare International (HHI) interviews Melissa Powell, Chief Operation Officer at The Allure Group in Brooklyn, NY in the AHCA Provider Lounge.  Melissa discusses how The Allure Group has established best practices for both CJR and Cardiac bundled payment models.   Melissa's homes have built an impressive, niche programming around the Cardiac patient - which both she and her facilities are extremely proud of. (Audio transcription below).



Missed Kris' Interview with KJ Page, Administrator at Chaparral House.  You can view it by clicking here. 


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Transcribed Audio:

Kris Mastrangelo:  Good afternoon.  Today we're here with Melissa Powell, the Chief Operating Officer of the Allure Group in New York City.  Before we get started I have to tell you a little story because Melissa Powell will host our events and our trainings and we talked readily about the Ritz-Carlton and service delivery especially with the regulations and in the Ritz-Carlton one of the methods is you never point, you always walk - so when I went into your building and I was speaking on the Great Eight - I walked into this amazing facility in Brooklyn New York and I was warmly received by the receptionist and instead of pointing to where the training room was you had staff lined up to escort all the attendees up to the room.  It wasn't really that difficult - it was only up one floor in the elevator and to the right.  You could easily have put signs but it's that level of service that sets you apart and it's amazing so I have to say that to the to the audience before we get going.  All right so Melissa how are you today?

Melissa Powell:  Good, thank you.

Kris:  You have a vast vast amount of experience.  We could talk about so many things today but let's chisel it down and let's talk about CJR, cardiac and maybe some quality measure stuff but tell us your experience, what's happening with your operations and how's it going.

Melissa:  So I think CJR has been a positive thing in the short-term and long-term care arena.  I think what it allows or what's blossomed from it is real strong clinical data being analyzed in the proper way.  People like myself at a c-level really questioning what's happening on the frontline.  You know, are people getting better, how long is it taking them to get better?  What are the barriers to getting them home quickly?  You know, are we discharge planning from day one like we are supposed to be doing and are we doing that not only from day one but from pre-admission and then in that process are we partnering with our hospitals in order to do that.  So I think what I've seen in Brooklyn through the partnerships is a strong relationship not only at the executive level but at the line level.  My rehab directors are communicating with my nurse managers and they're communicating with their counterparts in team meetings with the other hospitals.  We have certain hospitals that we communicate with weekly about our patients that are part of bundling.  We communicate about what barriers we've had to discharge planning – well this is a joint replacement and this patient should have been home in 10, 12, 14 days - why are they here still 16-18 days?  Sometimes things are out of our control and we've learned from that that the hospitals also need to help us with those expectations.  A big piece has been especially with the joints that a lot of people are coming in for maybe a second knee.  They did their first knee two, three or four years ago and they stayed in the subacute for 20, 30, 100 days depending on the subacute and I think the lesson is really communicating with patients and families that expectation right off the bat of where healthcare is today.

Kris:  Excellent.  So you have this exposure and you have this experience with the comprehensive joint replacement.  Now cardiac is on the table so tell me a little bit.  I know you've got experience with that.  So tell us about cardiac and what do you to anticipate.

Melissa:  So cardiac for my homes in particular is really a niche specialty.  We are very proud of the work we do with cardiac.  Our cardiac return to the hospital - those stats are next to nothing.  It's amazing the work we're doing and we have NPs on site and Cardiac physicians on site and there's a lot of special programming - niche programming done around that.  I think that the bundling of that particular cohort of patient is really going to lend the same kinds of positive outcomes to the facilities that maybe don't have the ability, that don't have a large corporate structure helping them and guiding them.  I think now some of those smaller operations across the country are really going to be able to look at best practices.  Our company's publishing best practices, you know and they'll be able to do some research and implement those things with the right guidance and I think it will help the patient.

Kris: We as an industry are very interested in those best practices for cardiac because those procedures and nuggets will help everyone escalate to the tasks that are going to be critical for success.  So people will be looking to you for that as well.

Melissa:  The management of a cardiac patient is not easy.  Now we had to increase levels of staff on the front lines and we had to do immense amounts of education and we had to bring in NP models and physician on-site models.  You know at a seven-day-a-week clip, not just once a week.  So I think that challenges our industry and I think that it is expanding our industry and it's only going to give us more of that stronghold in that preparation as the acute care hospitals are asked to send them to us earlier.

Kris: Melissa Powell from Allure Health Group.  Thank you so much.  We are interested in the nuggets for the cardiac program - the amount of staffing and maybe there's an increase or a decrease.  Thank you so much for coming and we'll see you soon.  Thank you.

Tags: Bundled Payments, CJR, AHCA Provider Lounge Series, Cardiac

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