Redefining the care continuum
From SNF to home
Dr. Benjamin Doga, LHC Group’s chief medical officer, oversees clinical processes, quality improvement initiatives, and a nationwide team of more than 600 medical directors. He received his bachelor’s degree in occupational therapy from Northeastern Louisiana University and his medical degree from LSU School of Medicine. He is a boardcertified practicing family medicine physician. He is also a clinical assistant professor of family and community medicine with Tulane Medical Center.
What does “continuum of care” mean at LHC Group?
BD: Our company was founded with the understanding that patients and families need better access to quality care – plain and simple. That’s what drives our success and sets a firm foundation for what we offer from a clinical standpoint. But we believe that the continuum is not defined by setting, and that it doesn’t necessarily end. In many cases, I think the care continuum exists only as long as intervention and treatment are necessary.
At LHC Group, we are focused on the fact that the care continuum exists throughout the life span of the patient, in illness and in health. Part of that focus means directing our attention to areas that are not traditionally associated with the “home health space.” Skilled nursing facilities are a great example.
So where does LHC Group fit in to this “new” space? Can you elaborate further?
BD: The post-acute care segment of our industry has been somewhat divided. On one hand, you have facilities; on the other, you have home care and outpatient providers. In many circles, I don’t think it was outrageous – once upon a time – to assume that we were all in some sort of perpetual competition with one another. We market to the same folks, we see many of the same patients, and there was quite a bit of overlap.
However, with the ongoing COVID-19 pandemic, we’ve observed that rather than compete with other providers for the same upstream presence, we can focus on those areas where we are the unilateral experts. There was some freedom in that epiphany. We’re more than capable of accepting patients from hospitals, SNFs, etc. – but we shouldn’t ignore the fact that the journey is not the same for all patients. Consider choice, for example: If an individual does not want SNF care, they may opt to discharge home. On the other hand, they may opt to discharge to the SNF ahead of a return to the community.
So, we’re seeing gaps, or hurdles, created in the care continuum that need to be addressed. From our perspective, the point of home discharge is our line of demarcation – whether coming from a SNF, hospital, or any other setting.
While most of the industry is talking about “diversion,” it seems like LHC Group isn’t necessarily trying to work around SNFs, but with them. Would that be a fair assumption?
BD: Yes, to a certain degree. I think it is more correct to say that we’re focusing on patients wherever they are at the point of discharge to the community. At this point, we know many patients benefit from SNF care, just as they do hospital care or home healthcare – that’s a given. There’s a portion of the population that “diversion” doesn’t address, and we think that’s a miss.
Again, it’s helpful to remember and understand where our company came from – and the mindset that we’ve developed over time: We want to make healthcare work better. It makes more sense for us to work with providers across all settings to make sure that when the day does come for a patient to go home, they do so with a level of care that specifically meets their individual needs. Our goal is to provide solutions to patients and partners. Thinking outside of industry norms and finding new ways to meet community needs is part of our DNA.
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