PITTSBURGH (Aug. 10, 2016) Highmark Health has established a new organization, HM Home and Community Services LLC (HM HCS), dedicated to transforming post-acute care by increasing quality, service and value for patients. Brian Holzer, M.D. has been named President of HM HCS. He will also continue to oversee AHN post-acute care operations, AHN Healthcare@Home, which he joined in 2013.
Post-acute care services have been cited as the source of 73 percent of the variation in Medicare spending and are used by almost 42 percent of Medicare beneficiaries discharged from a hospital.
"When patients are discharged from the hospital, it is crucial that they receive the right types of services in the right setting of care," explained Dr. Holzer. "Actively managing post-hospital care with evidence-based care pathways and tools for managing utilization and outcomes will be a major step forward for patients, their families, and their care teams. So whether patients need short term care in a skilled nursing facility or healthcare services in their own home, getting this right the first time helps patients recover from illness or injury and puts them in position for the best possible outcome."
Holzer and his team have spent considerable time interacting and evaluating skilled nursing facilities and home health companies across Pennsylvania and measured them against robust quality and service metrics. Recently, the team ranked the top 180 larger skilled nursing facilities currently in the Highmark network and invited their leaderships individually to Pittsburgh to discuss their results. "We received very positive and encouraging feedback. The leadership teams from these facilities generally want the same thing we want at HM HCS – for patients to have the best outcomes and experience," said Holzer.
HM HCS's first customer will be Highmark Inc., and it will manage post-acute quality, service, and cost for Highmark members across Pennsylvania. For Highmark members in Pennsylvania, there remains a 12 percent gap in 30-day readmission rates between high and low performing skilled nursing facilities in the Highmark network. "Ultimately, our goal is to improve outcomes and the member experience. We want the members and their support teams to know that they are not only receiving the right care in the right place but also by the highest quality post-acute care providers available. And by building high quality post-acute networks aligned to a shared vision with shared incentives, we expect HM HCS to transform the approach to post-acute care management both regionally and nationally."
Highmark Health, a Pittsburgh, PA based enterprise that employs more than 35,000 people nationwide and serves 50 million Americans in all 50 states, is the third largest integrated health care delivery and financing system in the nation. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to 5.2 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, Davis Vision and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, a community-based network of physician organizations, and a group purchasing organization, ambulatory surgery centers, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms. To learn more, please visit www.highmarkhealth.org.
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