The Centers for Medicare & Medicaid Services (CMS) is adding new metrics to its Value-based Purchasing Program each year, and case managers should look ahead to ensure that their hospital performs well on the measures.
Readmissions are a big factor in Medicare spending per beneficiary since an additional hospital stay adds significantly to the total cost of care, points out Susan Wallace, MEd, RHIA, CCS, CDIP, CCDS, director of inpatient compliance for Administrative Consultant Services, a Shawnee, OK-based healthcare consulting firm.
With the dual goals of increasing operational efficiency and promoting patient-centered care, Northwest Community Hospital in suburban Chicago revamped its care delivery model, adding a new role of clinical care coordinator to facilitate smooth and timely transitions from admission to discharge.
Readmissions are not just a hospital problem. They are a problem that extends across the continuum of care, and providers at all levels of care must work together to solve it, says Tania Daniels, PT, MBA, vice president of patient safety for the Minnesota Hospital Association.