In fiscal year 2016, 2,665 hospitals will receive lower Medicare reimbursements due to excessive readmissions within 30 days. But here’s the good news: 799 of those hospitals won’t be penalized at all – and your facility can join that elite club by skillfully using telehealth technology.
The number of penalized hospitals has been steadily increasing because CMS has added two new conditions – COPD and total hip/knee replacements – to the original trio of monitored conditions: heart attack, heart failure and pneumonia. The maximum Medicare withholding has risen to 3 percent – and only 38 hospitals reached that level in the last monitoring period. But even a 1 percent decline in Medicare reimbursement is a serious blow to any health system, large or small.
According to The Advisory Board, there are four key stages of care that determine whether a provider will incur or escape these penalties – and telehealth plays a vital role in two of them: post-acute care coordination and transitional care support.
At the recent Telehealth Innovation Forum, there were numerous presentations about how telehealth is improving post-acute care coordination across skilled nursing facilities, outpatient rehab, long-term care, home health and imaging centers.
Here’s how it worked before telehealth:
A patient would get discharged from the hospital, and the primary care physician often didn’t know about it for weeks, if ever. The skilled nursing facility had questions about the plan of care, but found it difficult to track down specialists. When patients finally went home, they were confused about when to make follow-up appointments – and with whom.
With telehealth technology, patients are better informed and clinicians know exactly who’s accountable every step of the way. The result: patient outcomes improve, hospital readmissions decline, and providers can provide follow-up care within Medicare’s 7- and 14-day timeframe in order to qualify for transitional care incentives. By CMS’s own estimates, timely transitional care can increase physicians’ revenue up to 4 percent.
The key to avoiding readmission penalties is to improve care across the continuum, not just talk about it. Telehealth is by far the best tool for accomplishing that.
Hospital Readmissions
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