Outsourcing Rehabilitation:A Pragmatic Approach to Opportunities

and Strategies

Alliance Rehab-SRA/SRA Mission and Vision

Mission:Strive to develop and deliver innovative products and

services designed to optimize the effectiveness of organizations servicing seniors

Vision:To be an integral part of the future success of the

organizations we serve

Innovation In Ohio:• New Model of Rehab Delivery

(Physiatrist-guided with Best Practices)

Alliance Rehab Company Profile

• First alliance-owned and managed rehab and fitness company established in response to PPS

• 1000+ employees providing services in 11 states• 100+ client facilities; 16 in Ohio area• All SNF clients are quality and mission-driven

organizations• 87 SeniorFITness™ Program sites• 26 In-House conversions to outsourced over the

past two years

Alliance Rehab Company Profile• Local Management structure includes full-time, on-

site Rehab Program Managers, Two Rehab Account Managers, Corporate Regional Director of Operations, and Corporate VP

• Rehab Best Practices Committee of 17 therapists across multiple states and chaired by Dr. Stambolis of Marianjoy Rehab Hospital

• Corporate Quality Management oversight• Benchmarking and Outcomes focus• Advanced clinical programming models for

improved rehab outcomes and facility differentiation

What Differentiates Alliance Rehab?

• First integrated Rehab and Fitness Model

• Assist facility in efforts relating to CMS’s Quality Initiative via enhanced clinical outcomes to targeted Quality Measures and Quality Indicators using advanced rehab technology

• Physiatrist-guided rehabilitation and fitness model utilizing Rehab Best Practices

• First rehabilitation company to offer innovative fitness programs specifically designed for the senior population using “Certified Senior Fitness Exercise Specialists” with integration into rehab

• Unique contract with UDS to certify, implement, and measure rehab outcomes using the FIM Instrument™

• Benchmarking from eleven states of rehab operations

• Proprietary Web-Based Rehab Information Software (ARIS 2.0)

Alliance Rehab-SRA Strategic Initiatives

• Advanced Rehab Programming Model, Non-Invasive Rehab for Incontinence Advanced Wound Care Contracture Management, Diabetes/Peripheral Neuropathy Rehab Programs Pain Management

• Implementation of Rehab Best Practices for Subacute/Post Acute Rehab and Long Term Care/Outpatient (inc.ALF and ILF)

• Dementia Initiative (Allen Cognitive)

• SeniorFITness™ Program to Create Rehab and Wellness Model• Fitness Best Practices for Seniors

• FIM Instrument™ Certification, Implementation, and Outcome Reporting

• Development of state-of-the-art Outpatient Rehab and Fitness Centers • Electronic Rehab Auditing and Compliance

• Patient Satisfaction Initiative

RUGs Utilization Pre and Post AR Operations (4 States)

Rugs Cat.

HVA

Pre AR Post AR(3rd Qtr’03)

RU 0% 22.6%

RV 11% 37.6%

RH 51% 32.6%

RM 38% 7.3%

RL 1% 0%

Rugs Cat.

CT

Pre AR Post AR(3rd Qtr’03)

RU 2.2% 18%

RV 23.6% 40%

RH 58% 31.3%

RM 14.2% 8.6%

RL .2% 1%

Rugs Cat.

AZ

Pre AR Post AR(3rd Qtr’03)

RU 2% 30%

RV 20% 49%

RH 71% 18%

RM 9% 3%

RL .1% .03%

Rugs Cat.

OH

Pre AR Post AR(44d Qtr’04)

RU 3.7% 21%

RV 29.5% 53%

RH 47.2% 20%

RM 18.2% 6%

RL 0% 0%

Outpatient Rehab Center Opportunities

• Non-Invasive Rehab for Incontinence (ACP)• Functionally-Based Pain Management Center

(ACP/Anodyne/Low Beam Laser Therapy)• Diabetic Neuropathy Clinic (Anodyne)• Advanced Wound Care Center (ACP/Anodyne)

• Advanced Orthopedic Rehab (ACP)

• Early Stage Dementia Clinic (Allen Cognitive)

Senior FITness Program• Participant sessions are

supervised and tracked

• Programming emphasis on improving:

– Strength

– Stability

– Flexibility

– Mobility

– Cardiovascular Health

• SeniorFITness is a senior focused wellness program

• Staff is degreed in Exercise Science and certified as SeniorFITness Exercise Specialists

• Fitness equipment utilized is senior friendly and designed to improve ability to perform activities of daily living

Rehab and Fitness Pricing

• Rehabilitation Services - Full Risk Arrangement Part A : RUGs per diem pricing based on a “per minute” pricing model Part B : Payment based on % of Fee Screen MCO: Payment based on “per minute” or % of MCO payment per visit

• SeniorFITness Option - Pricing Components:

Equipment - purchase, lease

Monthly fee for E.P.salary/benefits and management of SeniorFITness Program

Initial Fitness Assessment fee

Participant incentives