5 Aspects of CMS’ 2015 Proposed IPPS Regulations
On April 30, 2014, CMS announced proposed IPPS regulations to become effective January 1, 2015. The ruling covers: Hospital Value-Based Purchasing Program, Hospital Readmissions Reduction Program, Hospital-Acquired Condition Reduction Program, Quality Reporting Programs, and Wage Index – Updated Labor Market Areas.
CMS just announced proposed regulations to become effective January 1, 2015. These regulations further the goals of the Affordable Care Act: increasing patient outcomes and reducing healthcare spending. These proposed regulations are Medicare specific and, if approved, will be applicable to general acute care and long-term care hospitals.
The Impact of Reducing Avoidable Readmissions Infographic
What is the impact of reducing avoidable admissions and readmissions? What are you doing to track admissions and readmissions? Have you isolated the primary causes of avoidable readmissions? Do you have a game plan in place? Are you prepared to begin tracking additional readmission conditions beginning in 2015? Have you established relationships with primary care to ensure a smooth transition and continued care coordination? Are you currently being assessed penalties due to readmission rates being too high?
3 Reasons Your Readmission Rates Are Too High
Chances are, whether your on the administrative or clinical side of hospital operations, lowering readmission rates is high on your priority list. For administrators and financial officers, lowering the costs accrued from readmissions is paramount to staying under budget and for doctors and nurses, having patients prepared for life at home after discharge is the mark of truly community minded care. The patient-centered medical home purports medical decision making as an equal playing field; particularly when it comes to post-discharge measures of patient care.
Observation Units – Bridging the Gap Between Inpatient and Outpatient
What is CMS doing to reduce healthcare costs? CMS has added observation units which are an additional level of care between inpatient and outpatient.
What Are Observation Units?
In general, observation units are used to bridge the gap between inpatient and outpatient. They are designed for the patient in which the attending physician cannot determine whether a patient should be classified as outpatient (released within 48 hours) or inpatient (expected to stay at least 2 midnights). The observation units enable the physician to have a bit more time to stabilize the patient and based on medical necessity determine the estimated length of stay. They are billed as outpatient and do not count toward an inpatient admission.
