The Affordable Care Act introduced the first ever Hospital Readmission Penalty. The penalty was put in place to penalize hospitals who were slow to transform to value based care and preferred to stick with antiquated fee for service era practices. Having penned the best selling book of 2015 for the American College of Healthcare Executives titled Readmission Prevention: Solutions Across the Provider Continuum, former hospital CEO and nursing home administrator Dr. Josh Luke is the foremost hospital and post acute authority on the readmission penalty. This presentation covers the origins of and motivations for creating the readmission penalty, identifies key cause of avoidable hospitalizations, and shares current best practices for hospitals, doctors and post acute provider to prevent avoidable hospitalizations. The presentation also identifies tactics providers can take to improve internal protocols to reduce readmissions and emphasizes that the goal is to reduce all avoidable hospitalizations, not just readmissions. Special attention is given to emergency room tactics, as well as how case managers, social workers, doctors and post acute providers can play a role in enhancing communication to reduce avoidable readmissions. Specific attention is given to the new, 2019 CMS discharge planning rules that require hospitals to meet certain communication, medical record and transfer requirements.
- Attendees will understand the shift in control from the hospital to the insurance sector and how emergency department tactics for admission have changed and differ
- Attendees will understand how nurses, doctors, discharge planners and post acute providers can adopt best practices in adopting new procedures requiring enhanced communication and post-acute care planning in value based care
- Attendees will learn tactics to prevent avoidable hospitalizations and alternative placements for patients needing non-acute care