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The SCAN Foundation developed Linkage Lab in 2013 to help community based organizations update their business models to attract new business. In the first cohort, the foundation worked with six California organizations, spending $1 million on training.
St. Paul’s has yet to launch a partnership with a healthcare plan as most have told Wilson they’re poised to provide their own post-discharge care. “The chal- lenge was and it still is today that the plans are chal- lenged in finding their own footprint in this whole new health care world,” she said.
Need for Education Ripe Throughout Healthcare Continuum “Looking at how healthcare was changing, we certainly saw there was space for community-based organizations to really think about what it means for them to be part of the larger healthcare delivery system,” said Gretchen Alkema, the vice president of policy and communica- tions at The SCAN Foundation. Changes in Medicare’s billing goals have made senior
housing and community-based organizations logical partners for accountable care organizations. The po- tential for those relationships is relatively new. Seeking to reduce the price of patient care, Medicare in 2011 launched ACOs, medical groups that form voluntarily, working to improve patient health and reduce the cost of healthcare. If the ACOs are successful in helping Medicare save money, they get a portion of the savings as a bonus. If they’re not successful, they’re penalized. The change created a critical interest in post-discharge care among providers. Community-based organizations are often positioned
to help newly released patients get needed services and care, and new Medicare payment arrangements are giving medical providers greater reason to partner with those organizations. But medical providers are often unsure exactly what services CBOs provide. And many community-based organizations had been operating in the same or very similar ways for years. Even as their funding sources disappeared, decreased or failed to keep pace with the increasing cost of living, they hadn’t al- tered their menu of services. Given their growing fiscal
42 SENIOR LIVING EXECUTIVE / JULY/AUGUST 2016
needs, taking advantage of new opportunities meant altering business models for some of them. “Some of these folks had been in the (community
based organization) space for a long time and had done a great job, but they still had a learning curve,” Alkema said.
Linkage Lab Partnership Leads to Operational Changes St. Paul’s work with Linkage Lab led the organization to add electronic health records with all their services. Linkage Lab didn’t pay for the transition, but St. Paul’s raised money for the new equipment and software. St. Paul’s began the transition to electronic records when it opened a new building. New hires were told they’d need computer skills, and St. Paul’s trained them. Using a new property as a test site, the nonprofit perfected its electronic health records routines. One computer savvy person on each shift helped others transition. On-call tech staff were also available. The electronic records allowed them to get rid of
paper records and helped smooth resident relocations, whether they were going to a hospital or another St. Paul's community. St. Paul’s also changed its nursing stations to look
more like living rooms. Nurses now have the choice of using kiosks, iPhones or iPads for their records tracking. Alerts are also much quieter. “Everything is so quiet,” Wilson said. “It’s just – so
peaceful.”
6 CBOs participated in the first Linkage Lab cohort
in 2013-2014.
By the end of the program, these CBOs negotiated
27 contracts with 17 healthcare
providers with potential to serve more than
older adults and people with disabilities
16,000
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