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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.
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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.
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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.
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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.
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The Inpatient Prospective Payment System proposed rule for fiscal 2015 continues the Centers for Medicare & Medicaid Services move toward basing reimbursement on quality of care, not quantity.
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At MedStar Franklin Square Medical Center in Baltimore, discharges are facilitated by a multidisciplinary transitional care team, led by a transitional care nurse who fosters communication between disciplines and collaborates with post-acute providers to ensure that transitions are smooth and timely.
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Hospital efficiency of care, a new domain in the Centers for Medicare & Medicaid Services Value-based Purchasing Program, bases hospital scores on spending three days before admission through 30 days after discharge.
