Post-acute care strategy and operating-model transformation

A regional Medicare Advantage plan needed a more coordinated way to manage post-acute care across utilization management, provider networks, and care transitions.

Overview

A regional health plan serving approximately 100,000 Medicare Advantage members was experiencing sustained growth in post-acute care spending, particularly across skilled nursing facilities and home health.

The issue was not simply higher utilization. Post-acute care was being managed through several disconnected functions, making it difficult to identify the causes of cost growth or implement coordinated improvements.

The Challenge

Post-acute care activities were fragmented across multiple teams:

  • Utilization management focused on authorizations and continued stays

  • Network management maintained provider contracts

  • Care management supported selected high-risk members

  • Hospital discharge processes were inconsistent

  • Post-acute providers had limited visibility into plan expectations

Leadership could see rising costs but lacked clarity regarding what was driving them.

The Approach

1. Establishing a Performance Baseline

Developed an incurred-date view of utilization and cost to better understand admissions, length of stay, readmissions, discharge patterns, and provider variation.

2. Redesigning the Network

Evaluated post-acute providers using quality, readmissions, discharge outcomes, access, and total episode cost.

3. Improving Care Transitions

Moved utilization management earlier in the process and improved coordination around discharge planning, level-of-care decisions, and post-discharge follow-up.

4. Clarifying Build-versus-Partner Decisions

Defined which capabilities should remain with the health plan and which could be supported by outside partners.

Illustrative Results

  • Reduced skilled nursing utilization and length of stay

  • Improved discharge-to-home rates

  • Lower readmissions following post-acute stays

  • Faster initiation of home health services

  • Better visibility into provider performance

  • Meaningful medical-cost improvement

Business Impact

The plan moved from a fragmented and reactive approach to a coordinated operating model that aligned clinical decisions, network performance, member experience, and financial outcomes.

This case study is a composite example developed to illustrate Ivy & Anchor Advisors’ approach. Client details and results are illustrative.