Many of you have reached out requesting a newsletter or update from the National Readmission Prevention Collaborative (NRPC). Although we do not do a monthly NRPC newsletter any longer, at the public’s request I am providing an update on recent CMS updates and how hospitals are prioritizing new Alternative Payment Models and penalty programs.
I have met with executives and case managers in Colorado, Michigan, Florida , Utah, Nevada and California in recent weeks. While all are scrambling to ensure processes are in place to ensure successful implementation of Comprehensive Care for Joint Replacement (CJR), the Better. Smarter. Healthier. initiative (that requires 30% of claims to be paid through an Alternative Payment Model this year) appears to be just as much a priority.
Welcome to the homepage for the National Readmission Prevention Collaborative. This volunteer collaborative was created to unite industry leaders in sharing Best Practice Case Studies in care transitions and readmission prevention for hospitals, SNF's and other post acute providers. Please browse these "Best Practice" case studies to identify tools that may work at your facility in adopting to Affordable Care Act mandates. Many of the products, tools and services discussed in the case studies are available by clicking-through to the Resources section. Once you have put the Best Practices and industry-leading tools to work in your facility, we encourage you to submit your facility's success story as well! Thanks for visiting.
ABSTRACT: Seniors and other hospital patients in the United States have traditionally had the option of being discharged to a skilled nursing facility (convalescent home) for post-acute services, or home with nursing and therapy services provided in the home setting. Traditionally, these home based services have been referred to as "home health." As more Americans have retired, home health services have expanded and are readily accessible. This growth put tremendous stress on the Medicare fund which pays for senior care services. However, "Home Care," which traditionally has been viewed as non-medical home based services, has also become a booming industry for the cost conscious in recent years as more Americans reach retirement age. With the passing of the Affordable Care Act in 2010, providers and payers are now finding themselves responsible for post-acute care and continuous patient health, so cost efficient solutions for post-acute care are thriving. For the first time in history, American hospitals and Insurers are recognizing Home Care as an effective model that achieves the Triple Aim of Health Care reform. Home Care, which is no longer completely nonmedical services, has proven to be an integral part of the care continuum for seniors in recent years and is now becoming a viable solution for keeping patients well, while still honoring their desire to age and heal at home. This paper analyzes the benefits and risks of home care and provides a clear understanding as to why American hospitals are emphasizing SNF Avoidance and skipping home health, opting instead to refer patients directly to home care as the preferred discharge solution in a value based model.
INTRODUCTION: AFFORDABLE CARE ACT INCENTIVES FOR HOSPITALS & PAYERS TO DISCHARGE HOME
Healthcare spending for seniors continues to balloon at alarming rates as ninety percent of seniors prefer to age and heal at home, as opposed to in a healthcare facility, With approximately 8,000 baby boomers a day turning 65 years old, the nation’s senior population is estimated to increase by more than thirty percent by 2025. As a result, Medicare expenditures are projected to double to greater than $800 billion by 2018. These expenditures will have a significant impact on hospitals, health systems and payers as Alternative Payment Models (APMs) become law.
Eric Coleman, designer of Coleman Transitions Intervention; Eric Heil, CEO of Rightcare Solutions; and Josh Luke, hospital CEO and Founder of the National Readmission Prevention Collaborative, discuss MSPB (Medicare Spending Per Beneficiary), risk assessment and caretaker tools at the Northern California Readmissions Summit, September 12, 2014 in San Francisco.
Jennifer Pearce of Sutter Care at Home presented one of the hottest topics of the day,patient literacy. Sutter Health served as the educational underwriter for the event.
Glenna Yaroch of Home Instead opened up the Northern California Readmissons Summit by presenting a Best Practice case study on preventing readmissions through coordinated home care services.
Loren Shook, CEO of Silverado Senior Living and Author of The Silverado Story, was one of the most well-received speakers at the Northern California Readmissions Summit, Friday, September 12, 2014 in San Francisco.
(Choose from the options below by clicking your choice)
Thank you for taking the time to show us what you think. Below are the results of this poll.
July Poll Results
Does your hospital, facility or agency have a regularly scheduled care coordination/utilization review meeting with your acute/post acute partners/referral sources?
A. Weekly - 43%
B. Monthly - 7%
C. Both - 0%
D. Not At All - 50%
Poll question note: If you are struggling to get your referral source to engage you in regular meetings, please email info@NationalReadmissionPrevention.com, list "Poll Question" in the subject and then provide details, and we will connect you with resources to facilitate that conversation.
We would like to thank the following organizations for their support of our collaboratives.
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