Touchstone COO: No standstill in value-based care, improving partner networks, acquisitions and new construction

Texas-based Touchstone Communities hasn’t slowed down this year. The operator has been busy acquiring and building properties. In addition to the building innovations, Touchstone also partnered with Longevity Health in January to offer institutional special needs plans (I-SNPs) to its residents.

“It’s a very thoughtful, controlled growth effort aimed at asset diversification,” said Leslie Cunningham Campbell, COO of Touchstone.

Along with this growth is a narrowing of partner networks, Campbell told Skilled Nursing News. The Touchstone team chose its partners carefully because it seems that today there is a greater demand for responsibility for quality measures (QMs) that extends beyond the facility. Therefore, partners for care transitions need to be chosen carefully, she said.

“The payers do that, the hospitals do that – there’s a preferential status. If we’re going to be held accountable for what happens outside our four walls, both from a quality measurement perspective and from a reimbursement perspective, we better start narrowing our networks,” Campbell said.

In the midst of all this hectic activity, Touchstone also acquired four new residential communities as of May 1 and admitted its first patients to its newly constructed facility in Brownsville, Texas in June. Construction is also well underway on another newly constructed residential community in Montgomery County, near Houston, Texas.

Touchstone gained access to capital for such projects because of its close relationships and proven ability to generate a return on investment, she said.

This conversation has been edited for length and clarity.

What has Touchstone done in terms of growth or diversification?

We have not been sitting idle. I joined Touchstone in 2020 and since then we have opened a few communities. It is our first foray into the assisted living space, part of our diversification strategy and our intention to expand our ability to reach the resident or patient across the spectrum of care.

We’ve launched a home care agency, which is again part of our focused strategy to increase our reach across the spectrum. All of this will lead to value-based care. And then we’re opening another brand new, newly built community in Brownsville, Texas.

In Montgomery County, near Houston, Texas, construction of another community is already well underway.

We have installed dialysis units in both locations to meet market demand. We will be establishing a diabetes specialty unit at the Brownsville location.

We were very fortunate to have access to capital through close relationships and our proven ability to deliver our return on investment (ROI). We had locations where we could get beds, and in those cases we just picked up the ball and ran with it. In fact, we opened a newly built community in Penitas, Texas, in the middle of a pandemic.

The main reason for this was to keep the aircraft on the flight path during normal business operations.

What about changes related to value-based care and quality measures?

Just in January we launched an I-SNP, we took a stake in one so we actually own a piece of it. It was important for us to have a piece of it and not just be a player. All of this is to say that this is really about a paradigm shift. We are running the business as we have always done and thinking about the future, with value-based care.

If you don’t create the conditions for success today, you’re going to be left behind in the future. The introduction of all these strategic initiatives was aimed at that line. Part of that strategy was also to narrow our networks. That’s what the payers do, that’s what the hospitals do – there’s a preferential status. If we’re going to be held accountable for what happens outside our four walls, both from a quality measurement perspective and from a reimbursement perspective, we better start narrowing our networks.

We have done this very consciously: on the one hand, we have created our own opportunities, but on the other hand, we have reduced the number of our business partners, i.e. people with similar values ​​and a similar approach to care.

So have you become more selective in choosing your care partners, the hospitals, when it comes to value-based care?

We’ve started thinking about the transitions in care when someone goes to a dialysis appointment or a primary care appointment. With all of these things that can cost the system, we want to know how we can design transitions to reduce errors and hospitalizations.

And then what’s our value proposition for pre-admission? While we’re not necessarily held accountable for the outcomes in that area, we can definitely make a value proposition. Our value proposition is simply that we’re working with a very strategic partner that’s using AI and allows us to review hundreds of documents and medical records in about 15 minutes based on algorithms that we’ve developed, rather than spending three to four hours beforehand going through the whole thing.

This will allow us to reduce hospital stays faster, reduce costs and then hopefully increase volume. But ideally we want to be the solution. It will also free up time. It will give our nurses more time to be at the bedside of our patients.

This doesn’t bring us any revenue at first, but that is our value proposition.

Would you like to mention any long-term goals?

We are launching a strategic partnership with a dialysis provider. We believe this gives us unique differentiation in our markets. We have also gradually rolled out this whole care transformation approach. This gives us resources that we provide before the resident comes to our community and then follow the patient after they leave our community.