On October 1, 2012, the Hospital Readmissions Reduction Program (HRRP) will become effective as part of the March 2010 Patient Protection and Affordable Care Act (PPACA). This program requires the Center for Medicare and Medicaid Services (CMS) to reduce payments to hospitals with excess readmissions for unnecessary readmissions within 30 days of discharge if the patient has acute myocardial infarction (AMI), pneumonia (PN) and heart failure (HF). CMS views three stages related to readmissions:
- Inpatient care processes
- Effective discharge (soon to be termed transitional level planning)
- Post discharge or transitional care
This is just another step the Federal Government and CMS are taking to appropriately manage a patient’s care and the associated cost across the care continuum.
In the new era of Healthcare Reform, home care and hospice leaders play a vital role to ensure the appropriateness of care, in the right setting.
Solidify Strategic Partner Relationships.
- Identify key strategic referral and care coordination partners who demonstrate performance strength and value in the care continuum.
- Solidify relationships with physicians who are aligned with the hospitals you serve.
- Align with strategic “partners” (e.g., hospitals, subacute facilities, therapy organizations, physicians, consultants, pharmacy providers, software vendors, medical supply companies, etc.) who can assist in the development and integration of a comprehensive approach, including clinical, operational and financial performance.
- Build upon your hospital and referral strategy. Have a plan to get in front of C-suite executives who are making partnering decisions now.
Create Your Best Practice Model for Collaboration and Coordination of Care.
- Develop a best practice approach to disease state management to support ACOs, hospitals, physicians, payers and community-based providers who will be sharing the risk for payment.
- Track and monitor outcomes for continuous improvement of your hospital transfer/readmissions rates by top diagnosis. Have this data readily available when meeting with key referral sources.
- Align care delivery protocols to complement hospitals and physicians in the care continuum.
Embrace Your Unique Position to Ensure Appropriate Care Transitions.
- Implement OASIS + holistic assessments (e.g., depression, health literacy, rehospitalization risks, etc).
- Implement consistent identification of signs and symptoms that may lead to hospitalization and identify ongoing disease and symptom management protocols.
- Institute interdisciplinary team assessments, interventions, and care coordination across the continuum of care (e.g., Acute, Skilled Nursing, Home Care and Hospice). Review rehospitalizations and Emergency Department visits at weekly team meeting.
- Invest in technology that can assist in seamless review of data in order to showcase ongoing quality focus process and outcome measures.