Southwestern Health Resources Accountable Care Network Three-Day Rule Waiver: Approach to Communication and Implementation (Case Study)

Southwestern Health Resources Accountable Care Network Three-Day Rule Waiver: Approach to Communication and Implementation (Case Study)

Learning Systems for Accountable Care Organizations
Published: Jun 30, 2019
Publisher: Baltimore, MD: U.S. Centers for Medicare & Medicaid Services
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Associated Project

Learning Systems for Accountable Care Organizations

Time frame: 2013-2020

Prepared for:

U.S. Department of Health and Human Services, Center for Medicare & Medicaid Innovation

Key Findings

Using this strategy, SWHR ACN has continued to increase waiver-related SNF admissions since initiating the program. SWHR’s experience is informative for ACOs that seek to implement or optimize processes for using the SNF three-day rule waiver.

This case study describes the implementation strategy used by Southwestern Health Resources Accountable Care Network (SWHR ACN) for the skilled nursing facility three-day rule waiver, a benefit enhancement for organizations in the Next Generation Accountable Care Organization model. SWHR ACN’s approach focuses on establishing a high quality SNF network, engaging early with multiple stakeholders, developing waiver-implementation workflows, and embedding care managers in SNFs.

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