Many Hoosier hospitals are finding out the hard way that Medicare fines aren't something to laugh at. Recently, the Indiana Business Journal (IBJ) published an article stating that 62 Indiana hospitals were facing Medicare penalties due to, of all things, readmission rates.
As part of the Affordable Care Act (ACA), hospitals and healthcare networks are now tasked with providing efficient medical care to patients that keeps them healthy long-term - healthy and out of the hospital. This rule was put in place to counteract the 'volume over value' mindset that had shrouded the healthcare industry for the past decade or so. In this situation, healthcare organizations were paid based on how many patients they were able to move through their system, which resulted in quick, often sub-par service. In order to implement true value-based initiatives and refocus healthcare on the patient, the ACA doubled down on quality service and outcomes.
It's easy for health systems to lose sight of patient outcomes during the busy day-to-day activities of running a hospital, which could be the reason so many hospitals are now facing Medicare fines due to readmission rates. Luckily, there are now innovative solutions that not only help healthcare providers deliver on value-based care initiatives but also help hospitals as a whole reduce overall readmission rates.
With focused health consumer management solutions in place, health systems can effectively:
- Stratify and organize large patient populations for detailed analysis.
- Identify patient care gaps to immediately pinpoint any red-flag situations or patients.
- Maximize employee impact and revenue by refocusing initiatives and strategy.
According to the IBJ, Indiana ranked 31st among states for readmissions-based Medicare penalties, which although in the back half of the country is still too high to be comfortable. Indiana hospitals must continue to look for ways to take action on large patient populations to ensure nobody slips through the cracks.