From Aspiration to Outcomes: Building a Post-Acute Care Collaborative That Works

This case study examines how a structured Post-Acute Care Collaborative between a regional non-for-profit health system (The System) and a network of sub-acute rehabilitation facilities produced measurable improvements in patient safety, care quality, and family satisfaction. The collaborative was built on a foundation of high trust, defined roles of engagement, and a shared commitment to patient-centered outcomes — and it demonstrates what becomes possible when partnership moves from aspiration to operational reality. 

Success under TEAM will depend on more than preferred provider networks. It will require aligned care models, coordinated therapy models, and durable partnerships with SNF operators with aligned incentives. The opportunity is clear - post-acute care must be seen as a strategic extension of a hospital delivery system. Although TEAM impacts only five surgical procedure areas and is mandatory in approximately 700 US hospitals, the writing is on the wall unmistakenly pointing towards further expansion of this model to more diagnoses and more hospitals. 

Having a robust post-acute network and well-coordinated care between the hospitals and SNFs will guarantee that hospitals succeed in TEAM-like payment models. The work that went into building the post-acute chassis will yield great results in the years to come.