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Hospitals may eventually receive some relief from the burdens of the Centers for Medicare & Medicaid Services (CMS) Recovery Auditor (RA) program (previously called the Recovery Audit Contractor [RAC]) program but dont think the RAs are going away.
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Hospitals that appeal their denials by the recovery auditors (RAs) recoup their money 75% of the time, according to data provided by the American Hospital Association. But, only 40% of denials are appealed.
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The multidisciplinary team on each unit at Springfield Regional Medical Center in Springfield, OH, holds short team huddles at a specific time every day and reviews each patient, the plan of care and goals, and what needs to happen each day.
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After Springfield Regional Medical Center in Springfield, OH, began daily multidisciplinary team huddles to facilitate patient care, the hospitals performance on targeted core measures rose to the 95th quartile compared to a range of 75% to 81% when the project began, and the housewide ratio of the observed-to-expected length of stay decreased from 1.15 to 1.07.
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The American Hospital Association reports that 88% of all hospitals responding to its RACTrac Web-based survey have received an audit under the Recovery Auditor (RA) program.
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The focus on patient flow in the hospital setting began in the 1990s, when emergency department (ED) overcrowding became a serious threat to patient safety and quality of care.
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If your hospital receives high scores on the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS), 30-day readmission rates are likely to be low, according to a study by Press Ganey, a South Bend, IN, health care performance improvement organization.
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Since University Hospitals Case Medical Center in Cleveland, OH, embarked on a quality improvement initiative that included a redesign of the case management process, length of stay has dropped by almost a full day, readmissions have decreased, and the hospital's performance on 30+ metrics has increased.
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In a recent multi-specialty review of claims, The Doctors Company, a Napa, CA- based medical malpractice insurer, noted an increase in the number of claims filed by patients who were overweight or obese, reports chief patient safety officer Robin Diamond, JD, RN.
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Most of us cringe at thought of someone suing us. How rude! But it does happen, and we all need to be reminded of what to do to protect ourselves.