The introduction of value-based care highlights the systemic inefficiencies of the pay for performance model that contribute to unnecessary spending and poor patient outcomes. In fact, unplanned hospital readmissions cost anywhere between 15 to 20 billions dollars annually. With the renewed focus on quality of outcomes vs quantity of services, providers and hospital networks are paying closer attention to how quality care is quantified and delivered.
As part of the value-based care model, hospitals cannot afford to report poor performance outcomes for fear of losing payment adjustments. Based on the Hospital Readmissions Reduction Program, hospitals that report an excess readmission ratio of 1.0000 or higher receive a lower Medicare reimbursement and are penalized. Additionally, providers who have a low Merit-Based Incentive Payment System performance score against the Centers for Medicare and Medicaid Services’ benchmark are penalized and/or denied a payment adjustment.
With hospital budgets at risk, healthcare leaders are more motivated than ever to leverage holistic solutions that help build transparency and prioritize care performance in order to reduce hospital readmissions.
In order to reinforce the new patient care model, hospital executives need to learn how to best support the teams delivering care and better understand the inherent challenges associated. Forward-thinking hospital leaders are turning to sophisticated SaaS technology to obtain better insight into their partners’ performance, incentivize excellence across their market, and refresh workflows with digital enabled innovation.
Working Towards Value-Based Care
Reducing hospital readmissions is an important approach to meeting the new standards within value-based reimbursement programs. To avoid unnecessary readmissions and better prepare hospital systems to care for more patients, voids in communication and data across the healthcare spectrum must be addressed.
Reducing Readmissions, Increasing Capacity
A study conducted on strategies to reduce readmission rates in Missouri capitalized on the distinct correlation between the bottom line and reducing readmissions. As referenced in the study, “reducing hospital readmissions is a critical objective for hospital leaders because readmissions affect the financial viability of both the hospital and the community in which the hospital resides.”
One way that leadership can take active strides in reducing readmissions is strengthening the lines of communication between providers, case managers, and post acute facilities and providing the necessary resources to offer better patient care.
Ensuring easy access to available high quality post acute facilities is especially impactful in reducing readmissions. Within each healthcare ecosystem, there is an opportunity to align workflows and incentives with post acute facilities to effectively bring them into the readmission conversation. Traditionally, post-acute placement “best practices” discharge patients to the providers closest to home and fastest to respond. When communicating with consistent, transparent workflows and measures of success, health systems are leading entire healthcare communities to operate more efficiently by moving patients faster to the best available provider. Executives are realizing the power of technology by providing tools that equip staff not to replicate paper workflows on computers, but to re-design the most common yet tenuous workflows – post-acute placements, authorizations, simple signatures and documentation – to take maximum advantage of modern technology. From a systemic view, patients more promptly receive more customized quality care, leaving more room to welcome new patients.
Reduce the Cost of Hospital Readmissions with Aidin
Aidin’s referral management software is an essential tool to help hospitals be successful within the value-based reimbursement model. A revolution to the transitional care process, it provides visibility and access to all participants within the healthcare spectrum. Participants in the Aidin care community are given a ranking based on their responsiveness, reliability and care outcomes to help hospital systems develop trusted partnerships and build custom networks. Hospital executives will also enjoy utilizing the performance reporting feature to find new opportunities for improvement within their individual teams. In addition, hospital leadership can make better strategic business decisions through Aidin’s zip-code specific supply-and-demand data and market insights. Using Aidin’s analytic capabilities, hospital executives can better evaluate their facility’s progress from both a departmental and systemic perspective.
With the support from Aidin, leadership teams can look forward to:
- Increase capacity by adding 1500 new patients
- Reduction in LOS by .86 days
- Millions of dollars in cost savings per hospital, per year
- 25% reduction in post-acute readmissions
At its core, Aidin envisions a healthcare ecosystem where there is more transparency and visibility at each stage of the care continuum. Connect with us to learn more about Aidin’s offerings.