Ensure that your organization is taking the proper steps to implement routine reviews and stay in compliance. Use TCG Compliance Solutions for ongoing audit assistance, continuous improvement and ongoing education.
Since October 1, 2012, the Hospital Readmission Reduction Program (HRRP) that penalizes hospitals with high readmission rates for certain conditions within 30 days of discharge has been in effect. For the first two years, acute myocardial infarction, pneumonia and heart failure will be the only applicable conditions on which readmission rates will be calculated. Beginning in 2015, however, CMS will add additional conditions or procedures it believes represent high costs and high volumes of readmission.
As post-acute providers, you have a vital role in ensuring appropriate care transitions to and from acute care settings.
Track and Measure Key Metrics.
- Use key metrics to show your acute care partners that your organization is at or above industry standards, such as: Patient outcomes related to hospital admissions and ED visits, and HH-CAHPS scores.
- Establish other measures and value points that demonstrate your success as a solution partner.
Establish and Monitor Your Care Transition Best Practice Model.
- Promote specialty programs that show evidence of success in reducing unnecessary re-hospitalizations and improving coordination across care settings.
- If your organization does not have such programs, identify what programs would be of most value to your local health system; collaborate with teams from the hospital, nursing homes and physicians to develop and implement a transitions of care program to assist the health system reduce re-hospitalizations.
- Prepare to cover the cost of non-reimbursable services.
Reserve a Seat at the Table.
- Ensure your team has the knowledge and resources to ‘sit at the table’ with an ACO or health system.
- Ask to have a seat at the table and be prepared to demonstrate why your organization should be part of their solution.