One hospital in North Carolina suffered a penalty of $942,000 just for its readmissions.
Collierville, TN (PRWEB) March 19, 2015
LifeWings Partners LLC today announced the release of a free toolkit to help health care leaders avoid penalties levied by the Centers for Medicare & Medicaid Services (CMS) as a part of its effort to link Medicare payments to the overall value of care instead of the volume of services provided. A part of the Affordable Care Act, the penalties could affect reimbursements for patient stays at 3,500 hospitals.
The penalties are levied on hospitals when their quality measures fall below CMS benchmarks. For example, hospitals can be penalized for readmitting patients within 30 days of an initial discharge. Failure to meet other performance measures, including the number of hospital-acquired conditions such as surgical-site infections and ulcers, and four broad areas of value-based purchasing (patient experience, outcomes, process of care and efficiency) will reduce Medicare payments by an estimated 1 percent at more than 700 hospitals in fiscal year 2015. Although the average penalty is $125,000, hospitals with certain risk factors and, alarmingly, the facilities that provide the critical safety net for underserved populations, can be hit especially hard. One hospital in North Carolina suffered a penalty of $942,000 in fiscal year 2015 just for its readmissions.1
These penalties will have a significant impact on hospitals’ bottom lines, force tough choices for hospital leaders, and have potentially long-term effects on patient access, quality of care and quality of life in many communities.
Recognizing the dire consequences of inaction, LifeWings CEO Steve Harden produced a CMS Reimbursement Survival toolkit for health care leaders. Mr. Harden stated that, “If hospitals don’t have a method to systemically improve performance in these measures, they will likely resort to staff cuts, which would have a negative impact on future performance and create a cycle of deteriorating care and financial unsustainability.”
LifeWings has a proven track record of helping hospitals improve the measures that contribute to these penalties. After completing its improvement program, one of LifeWings’ partner hospitals in Georgia reduced its surgical-site infection rate from 0.65 percent to 0.37 percent and saved $828,000. A hospital in Minnesota implemented LifeWings improvements, which helped prevent eight wrong-site surgeries in just one year, and a large facility in New York has documented a return on investment of more than $2.7 million from its program.
To help health care leaders implement these proven fixes, LifeWings documented results from numerous facilities in its free CMS Reimbursement Survival Toolkit Success Stories presentation. Additionally, health care leaders can attend a free 20-minute webinar on the specific items they need to address to avoid penalties, including: how to select the right person to communicate the changes needed, how to get staff and physicians on board, a simple way to measure results, and how to gauge staff alignment around the new processes. Health care leaders can request the free webinar by contacting Steve Harden at sharden(at)saferpatients(dot)com.
LifeWings is a team of physicians, nurses, Toyota-trained Lean experts, health risk managers, astronauts, military surgeons and flight crews. The team was the first in the U.S. to study the best practices of organizations with high reliability, and successfully adapt their strategies for use in health care. They have distilled the methodology used in commercial aviation, military aircraft carriers, nuclear submarines and cutting-edge manufacturing to help health care organizations create safe, efficient, high-quality hospitals and clinics.