The federal government is reducing payments to hospitals that readmit too many patients, but improving your facility’s discharge process can help you avoid payment reductions. Staying on top of the latest programs and regulations from the Centers for Medicare & Medicaid Services (CMS) is crucial in this area.
The Feds Want Fewer Readmissions
Discharging patients from the hospital is a complex process that is fraught with challenges. Almost 20 percent of Medicare patients who are discharged from a hospital are readmitted within 30 days. Unplanned readmissions cost $17.4 billion in 2016 and accounted for 17 percent of total hospital payments from Medicare. Both Congress and CMS have made it a major priority to cut down on readmissions.
Research suggests that anywhere between 44 percent and 76 percent of hospital readmissions are preventable. Preventing avoidable readmissions can profoundly improve both the quality of life for patients and the financial wellbeing of health care systems.
Under the Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP), CMS will withhold $528 million in payments in 2017—an all-time high and an increase of about $108 million from FY 2016. And the federal IMPACT Act has resulted in reduced payments to hospitals that have a higher than average readmission rate for a variety of conditions, including new ones in 2017. New evidence-based research is coming out every day on recommendations to help reduce unnecessary readmissions.
Reengineer Your Discharge Process
Join the upcoming live audio conference “Preventing Hospital Readmissions Through Discharge Planning” with noted expert Sue Dill Calloway, RN, MSN, JD., on Wednesday, April 12, 2017 to learn about strategies to prevent readmissions in light of the most recent programs at CMS.
This session will discuss the impact of key federal laws and how to prevent hospital readmissions. It will also provide details on the most recent evidenced-based studies, as well as future studies that aim to reengineer the discharge process. Sue will discuss key quality measures and information that must be included in the admission assessment, as well as CMS’s latest discharge planning standards. Attendees will learn about discharge summaries that must be sent to physicians within 48 hours, as well as required medication reconciliation and information that must be provided to patients about side effects of their medications. All these issues, among others, will be covered during this two-hour session that is a must-attend for medical professionals from hospital CEOs and CFOs to compliance officers, and from health information managers to nurses and discharge planners.
