Higher Readmission Penalties = Even Greater Agency Opportunity
Posted On: June 17th, 2014
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
Hospital penalties for readmissions within 30 days are working. CMS said in a recent press release that Medicare readmissions declined by 150,000 from January 2012 through December 2013. Around 2,225 hospitals were fined more than $227 million by Medicare in 2013, according to federal data.
In 2015, the readmission penalty for five conditions will increase from 2% to 3%, giving hospitals an even greater incentive to step up their post-acute care coordination and providing home health agencies with an unprecedented opportunity to show their value in helping to bring down readmission rates.
Case managers at hospitals and rehabs are looking for well-established, well-disciplined agencies that provide good care to whom they can make safe referrals, Lenny Verkhoglaz, CEO of Hackensack, NJ-based Executive Care tells Healthcare Finance News.
A spokesperson for the National Association for Home Care and Hospice agrees, saying that to position themselves as suitable partners, home health agencies need to evaluate their own performance and determine how they can improve and then offer their performance data to hospitals. NAHC also says that, if needed, agencies should develop new programs and offer training to their staff to make sure they can deliver the services and care sought by hospitals.
In an article in Hospital & Health Networks Daily, RN Terri Marshall recommends home health agencies and hospitals work together to develop disease-specific programs that track patient data and create plans to reduce readmission rates.
In another data-related recommendation, the Alliance for Home Health Quality and Innovation advocates the exchange of OASIS data as a way for hospitals and home health agencies to work together. “[OASIS data on medication management, dyspnea management, pain, and functional outcomes] is often predictive of patients who are at risk of readmission,” the alliance writes in a paper on home health care data and readmissions.
The paper goes on to recognize that hospitals have data that’s important to home health providers seeking to improve outcomes, including inpatient hospital discharge dates, information on whether a patient was hospitalized or rehospitalized, and reasons for the patient’s hospitalization or rehospitalization.
Not surprisingly, the alliance calls for standardized, interoperable health records as a way to enhance collaboration and information sharing.