how does the medicare hospital readmissions reductin program affect long-term care organizations

by Sonya Dare Published 3 years ago Updated 2 years ago

What is the Hospital Readmissions Reduction Program? HRRP is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.

The Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.Dec 1, 2021

Full Answer

What impact has the hospital readmissions reduction program had on hospitals and patient care?

Specifically, readmission rates decreased more for high-risk patients than for low-risk patients, and, in the case of Medicare AMI patients, decreased more for Medicare patients from low-income hospitals than for Medicare patients from high-income hospitals.Nov 14, 2019

Why is the hospital readmissions reduction program important?

Why is the Hospital Readmissions Reduction Program important? HRRP improves Americans' health care by linking payment to the quality of hospital care. CMS incentivizes hospitals to improve communication and care coordination efforts to better engage patients and caregivers on post-discharge planning.Dec 1, 2021

Is the Hrrp effective?

Importance: The strongest evidence for the effectiveness of Medicare's Hospital Readmissions Reduction Program (HRRP) involves greater reductions in readmissions for hospitals receiving penalties compared with those not receiving penalties.Apr 1, 2020

What has the biggest impact on hospital readmission rates?

While investing in such material assets is easily done and provides immediate gratification, findings from our research using six years of data from nearly 3,000 acute-care hospitals suggest that it is the communication between caregivers and patients that has the largest impact on reducing readmissions.Sep 23, 2015

How does Medicare reimbursement affect hospitals?

Under this system, hospitals receive a fixed payment for each patient that is determined by the patient's diagnosis-related group (DRG) at the time of admission; thus, reimbursement is unaffected by the hospital's actual expenditures on the patient.

Why is hospital readmissions a problem?

Hospital readmissions are associated with unfavorable patient outcomes and high financial costs. Causes of readmissions are multi-factorial and rates vary substantially by institution. Historically, nearly 20% of all Medicare discharges had a readmission within 30 days.

What is the aim of the hospital readmissions reduction program Hrrp )? Quizlet?

The Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that reduces payments to hospitals with excess readmissions. The program supports the national goal of improving healthcare for Americans by linking payment to the quality of hospital care.

Why did hospitals have limited incentives to reduce readmissions before the ACA?

Hospitals had limited incentives to reduce readmissions prior to the Affordable Care Act (ACA)because before ACA hospitals gained income for patients that were in and out of the hospital.

Does Medicare penalize hospitals for readmissions?

For the readmission penalties, Medicare cuts as much as 3 percent for each patient, although the average is generally much lower. The patient safety penalties cost hospitals 1 percent of Medicare payments over the federal fiscal year, which runs from October through September.Feb 3, 2022

What is the hospital readmission reduction program?

How does hospital readmission affect patients?

For instance, in-hospital mortality has been found to be higher for patients who are readmitted versus those who are not. Other researchers argue that readmissions lead to an increased length of stay and expenditure of more hospital resources.

How can hospital reduce readmission rates?

Let's examine 7 strategies to reduce hospital readmissions:

1) Understand Current Policy. ...
2) Identify Patients at High Risk for Readmission. ...
3) Utilize Medication Reconciliation. ...
4) Prevent Healthcare-Acquired Infections. ...
5) Optimize Utilization of Technology. ...
6) Improve Handoff Communication.

More items...

What is a hospital readmission?

Hospital readmission measures have been touted not only as a quality measure, but also as a means to bend the healthcare cost curve. The Affordable Care Act (ACA) established the Hospital Readmission Reduction Program (HRRP) in 2012. Under this program, hospitals are financially penalized if they have higher than expected risk-standardized 30-day ...

How long does a heart failure patient stay in hospital?

Countries with longer length of stay for heart failure hospitalizations appear to have lower rates of readmission within 30 days. In a large contemporary acute heart failure trial conducted across 27 countries, mean length of stay ranged from 4.9 to 14.6 days (6.1 days in the U.S.).

What is CCTP in healthcare?

The Community-based Care Transitions Program (CCTP), created by Section 3026 of the ACA, aims to test models for improving care transitions and reducing readmissions.22Notably, the CCTP directs $500 million only to hospitals who applied and were approved; it currently includes 102 organizations.

How long does it take for an unplanned readmission to happen?

Unplanned readmissions that happen within 30 days of discharge from the index (i.e., initial) admission. Patients who are readmitted to the same hospital, or another applicable acute care hospital for any reason. Readmissions to any applicable acute care hospital are counted, no matter what the principal diagnosis was.

What is HRRP in Medicare?

HRRP is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.

When did the HRRP start?

Section 3025 of the Affordable Care Act required the Secretary of the Department of Health and Human Services to establish the HRRP starting October 1, 2012 (i.e., Federal Fiscal Year [FY] 2013).

Delivery at discharge: Readmission prevention strategies

We know you are deeply committed to your residents’ wellbeing, and HealthDirect is here to help. Factors contributing to preventable hospital readmissions are complex, varied and may include environmental, community and resident-level factors.

Avoid Costly Fines with Coordinated Care

By working with HealthDirect, a skilled nursing facility (SNF) can adopt pharmacy-driven strategies to reduce hospital readmissions. The truth is, adverse drug events (ADEs) lead to nearly 100,000 hospitalizations per year, and fatal ADEs are estimated to rank among the top six leading causes of death in the U.S.

Readmission Prevention Strategies for Diseases

The Delivery at Discharge program offered through HealthDirect helps Skilled-Nursing Facilities prevent readmission to hospital following discharge and avoid fines by supporting post-discharge medication compliance. This unique and innovative program applies to high risk discharges and focuses on CMS identified conditions. (OIG report, Nov 2013).

How to improve the accuracy of calculations

Shen doubted executives at individual hospitals could determine whether their organization wrongly faced HRRP penalties, given that they would need access to other hospitals’ data as well.

Significance of the penalty issue for hospitals

The latest CMS data showed 2,545 hospitals will face FY21 HRRP penalties, with 41 facing the maximum 3% cut in Medicare payments. The HRRP produced $553 million in hospital cuts for FY21, CMS estimated. That was a slight decrease from FY20, when 2,583 hospitals incurred $563 million in penalties and 56 hospitals had the maximum cut.

About the Author

is based in the Washington, D.C., office. Follow Rich on Twitter: @rdalyhealthcare

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