VALUE-BASED CARE

Assisted living, value-based care share common goal of better outcomes for residents

EVOLVING ASSISTED LIVING MODEL

More care coordination on-site clinical care in assisted living facilities

The increasing age of residents along with the growing medical complexity they bring is making it necessary for assisted living providers to offer some degree of care coordination. A model blending medical and social approaches is needed to keep increasingly frail older adults with medically complex health in the setting of their choice over time.

The Post-Acute and Long-Term Care Medical Association (PALTmed) encourages medical providers to consider offering on-site care in assisted living communities. Doing so makes life easier for residents, and collaborating with assisted living staff members and resident families improves the care model.

Chronic care management and value-based care plans are two of the most common ways healthcare providers can deliver care to assisted living residents while recouping costs and make a profit.

IMPLEMENTING VBC

Excelas can help facilitate the transition to value-based care (VBC)

Excelas gives assisted living facilities and healthcare providers moving into value-based care a way to shore up documentation, risk, and litigation exposure while freeing internal teams to focus on outcomes and operations.

1. Stronger documentation to support value-based payment –
   • Excelas’ work product identifies documentation gaps that could undermine quality scores, share-savings calculations, or post-acute performance metrics
   • Excelas’ analyses frequently surface missing assessments, inconsistent narratives, and incomplete incident documentation, especially around falls, wounds, and behavior
2. Proactive internal audits tied to regulatory and payer risk
   • Internal audits help providers correct issues before payer review or lawsuits, aligning clinical practice, billing, and quality reporting with CMS and state expectation
3. Scalable medical-legal capacity without adding FTEs
   • Excelas delivers comprehensive medical/nursing analysis and record management without providers needing to hire additional in‑house nurse reviewers or litigation support staff
   • Custom software and workflows for medical chronologies and document management make it possible to handle surges in reviews (e.g., new value‑based contracts, audits, or large claims) quickly and cost‑effectively
4. Deep long-term care and assisted living expertise
   • Excelas has specific experience in long‑term care and senior living, including assisted living vs. skilled nursing distinctions, CMS regulatory trends, and emerging plaintiff strategies in this space.
   • That sector‑specific perspective allows them to tailor analyses to typical ALF/SNF risk areas—falls, pressure injuries, staffing levels, and care transitions—that directly affect value‑based quality metrics and preferred‑network status

IN THEIR OWN WORDS

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Excelas helps organizations respond accurately and quickly to claims and litigation brought against them

Partnering with attorneys, health care organizations, and insurance companies since 1995, Excelas provides medical legal analyses and tools for building winning defense strategies. When expertise, accuracy, reliability, and on-time delivery count, you can count on Excelas.