Readmissions Archives - Page 3 of 4 - BHM Healthcare Solutions

The Penalty Box | CMS’ 3 Ways to Ding Hospitals

2017-04-02T13:28:35-04:00By BHM Marketing|Compliance, Financial, Financial Analysis, Health Care Reform, Medicare and Medicaid, Quality Improvement Programs, Readmissions, Services|

Are you one of many hospitals being dinged with CMS penalties? Are you ready to be dinged for Hospital Acquired Conditions, in addition to readmissions and value-based purchasing? How can a hospital remain profitable? In terms of hockey, the penalty box is where players are sent when they have committed an act which is against the regulations of the game. The player is forced to sit in the penalty box for a period of time, causing the team to play with less players, until the penalty time has lapsed.

The Top 5 Mistakes Hospitals With High Readmission Rates Are Making

2017-04-02T13:28:35-04:00By BHM Marketing|Care Coordination, Health Care Reform, Readmissions|

While there are plenty of complex reasons for high rates of readmission, there are plenty that are preventable. Here are the Top 5 Mistakes made by hospitals who top this list.

7 Ways to Improve Your Readmission Rates

2017-04-02T13:28:37-04:00By BHM Marketing|Care Coordination, Clinical Analysis, Health Care Reform, Readmissions, Services|

As most of us are aware, readmissions is a hot topic, especially in terms of the penalties assessed for readmission rates which are excessive. What can you do to reduce or eliminate your readmission rates? There has been a lot of talk about readmissions (avoidable), specifically the healthcare costs associated with them and the effects on the quality of patient care being provided. In order to crack down on these avoidable readmissions, CMS created the Readmissions Reduction Program. The premise of the program is to ding hospitals, with higher than average readmissions (readmitted within 30 days of discharge), by assessing penalties against overall Medicare payments. There has been a lot of hoopla surrounding the program, with many criticisms being cited, such as treating all hospitals alike, not accounting for socioeconomic factors, and the way the penalty is calculated.

Are You Ready for 2015 Readmission Penalties?

2017-04-02T13:28:37-04:00By BHM Marketing|Clinical Analysis, Health Care Reform, Health Insurance, Medicare and Medicaid, Readmissions, Services|

What are you doing to make sure you are not one of the 66% of hospitals who will be assessed readmission penalties in the next round? Can you afford the penalties which are increasing again in 2015? Are you aware of the proposed conditions to be added in 2015? What do you get when you combine Medicare, high readmissions, within a 30 day window, for specific conditions? A reduction in Medicare spending to the tune of about $280 million annually. Of interest is that penalties were assessed in 49 states, all with the exception of Maryland, who has a unique reimbursement payment system.

9 Criticisms to the Readmission Reduction Program

2017-04-02T13:28:37-04:00By BHM Marketing|Clinical Analysis, Compliance, Financial Analysis, Health Care Reform, Health Insurance, Medicare and Medicaid, Quality Improvement Programs, Readmissions, Services|

The Readmission Reduction Program is designed to reduce healthcare spending while improving quality. There are both proponents and opponents of the program. Let’s delve into the improvements that could be made to the current system. So, as most of you are aware, CMS under the direction of HHS created the Hospital Readmission Reduction Program in order to reduce healthcare spending while improving the quality of care. The program is being phased in beginning with a 3 year baseline period in which hospitals were required to report all readmissions (within 30 days). CMS assessed and analyzed all of the available readmission data to determine how penalties should be assessed, for which conditions, and excluding certain circumstances. Beginning in October 2012, penalties were assessed to over 2,200 hospitals, equating to about $280 million. The phase in included an increase in penalties from 2013 to 2015 from 1% to 3%, where it is currently capped. Initially, there were 3 conditions included: Acute Myocardial Infarction, Heart Failure, and Pneumonia. For 2015, CMS is proposing 2 additional conditions: Chronic Obstructive Pulmonary Disease and Elective Hip and Knee Replacements.

5 Aspects of CMS’ 2015 Proposed IPPS Regulations

2017-04-02T13:28:39-04:00By BHM Marketing|Clinical Analysis, Compliance, Financial Analysis, Health Care Reform, Medicare and Medicaid, Physician Compensation, Readmissions, Services|

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

2017-04-02T13:28:39-04:00By BHM Marketing|Clinical Analysis, Readmissions|

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

2017-04-02T13:28:39-04:00By BHM Marketing|Care Coordination, Clinical Operations Improvement, Readmissions|

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

2017-04-02T13:28:41-04:00By BHM Marketing|Clinical Operations Improvement, Financial, Health Insurance, Readmissions, Services|

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.

Patient-Centered Focus Increases Revenue

2017-04-02T13:28:41-04:00By BHM Marketing|Care Coordination, Financial, Medicare and Medicaid, Quality Improvement Programs, Readmissions, Services|

A patient-centered focus will provide optimal care for the patient which will in turn drive revenue. Do you remember the movie “Field of Dreams”? The basic premise was if you build a stadium they will come. We can adapt this adage to healthcare as well. So many organizations become so focused on the bottom line and don’t realize that if patients aren’t satisfied, they will not return to your facility, they will relay their bad experience to all of their friends, and you will lose revenue.

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