Avoid Medicare Reimbursement Penalties

One of healthcare reform’s first and largest pay-for-performance initiatives is focused on reducing unnecessary hospital readmissions. Starting in 2013, CMS will begin withholding a percentage of reimbursements for readmissions. These penalties will focus on the seven conditions that accounted for 30 percent of Medicare readmission spending in 2008, which are:

Heart Failure
Acute Myocardial Infarction
Pneumonia
Chronic Obstructive Lung Disease
Coronary Bypass Grafting
Percutaneous Coronary Interventions
Vascular Procedures

To proactively address readmission management, hospital management must identify, contact and coach patients who are prime candidates for preventable readmission. Care coordination, patient engagement and education, and comprehensive follow-up are all crucial elements to successfully addressing this issue. By adding technology and/or processes to accomplish these elements, you can reduce the possibility of being penalized for preventable readmissions.

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