1 The Impact of the ACA: How Readmissions Penalties Will Affect the Healthcare Executive’s Mission Healthcare Leadership Network of the Delaware Valley May 2, 2014 Paula A. Bussard Senior Vice President, Policy & Regulatory Services The Hospital & Healthsystem Association of Pennsylvania
14
Embed
1 The Impact of the ACA: How Readmissions Penalties Will Affect the Healthcare Executive’s Mission Healthcare Leadership Network of the Delaware Valley.
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
1
The Impact of the ACA:How Readmissions Penalties Will Affect
the Healthcare Executive’s Mission
Healthcare Leadership Network of the Delaware ValleyMay 2, 2014
Paula A. BussardSenior Vice President, Policy & Regulatory ServicesThe Hospital & Healthsystem Association of Pennsylvania
2
Preventable Readmissions
• 1 in every 5 Medicare patients are readmitted within one month of discharge.
• More than 2,000 hospitals affected by readmission penalties.
• About $270 million in Medicare funds. PA FFY 2013 - $12 million—PA ranked 32nd
PA FFY 2014 - $9 million—PA ranked 31st
• Increase in penalty to max of 3%.
3
Readmission rates for 2010, as reported by Pennsylvania Health Care Cost Containment Council (PHC4):
Total readmission rate was 13.5% (2 out of every 15 hospital stays had a readmission within 30 days).
CHF readmission rate was 24.3%. Septicemia readmission rate was
21.0%. COPD readmission rate was
20.2%.
Preventable Readmissions
4
Pennsylvania Hospital Engagement Network
HAP—one of 26 hospital engagement networks nationwide 60 Pennsylvania hospitals participating in the HEN collaborative
project:• 15 hospitals participated in one year BOOST project (Better
Outcomes for Older adults through Safe Transitions)• 45 hospitals in PA-HEN collaborative
Tracking readmission data for all Pennsylvania PA-HEN participating hospitals
PA-HEN has offered:• Regional networking sessions (including post-acute providers);
webinars; one-on-one coaching calls; and site visits• Priorities:
Health literacy training Post discharge best practices (appointments/phone calls) Medication reconciliation Patient education
55
0%
5%
10%
15%
20%
25%
30%
2010n=118
2011n=118
Q1 2012(Dec-Feb)
n=118
Q2 2012(Mar-May)
118
Q3 2012(Jun-Aug)
n=118
Q4 2012(Sep-Nov)
n=117
Q1 2013 (Dec-Feb)
n=118
Q2 2013(Mar-May)
n=118
Rate
PA-HEN Wide Readmission Results (Rate of 30 day readmissions, all-cause, CHF and COPD)
CHF Rate COPD Rate All Cause Rate
GOAL
Reflects a 24% reduction from
baseline
PA-HEN Readmission Progress
6
• Immersion project model• Health Literacy• Community Cross Continuum Teams
– Removal of silos– Collaboration with stakeholders– Regional events including health care and community