Medicare’s Latest Reason to Not Reimburse You

Posted December 5, 2016

readmissions-article

Beginning October 1, 2012, the Centers for Medicare & Medicaid Services (CMS) entered a program which required them to reduce payments to Inpatient Prospective Payment System (IPPS) hospitals with excessive readmissions. The goal was to promote lasting care for patients before sending them home and to end the “revolving door” of readmissions. A very honorable goal, but maybe not the only one.

In a letter from CMS’ Office of the Actuary, they state that adjustments must be made to the IPPS payment rates “in order to recoup $11 billion in fee for service overpayments associated with documentation and coding in FY’s 2008-2010 that have not been recovered through previously implemented adjustments to payment rates” (CMS.gov). Eleven billion dollars is a lot to make up for, especially when ‘previously implemented adjustments’ aren’t doing the job.

So maybe these updated rules and ‘necessary adjustments’ are in place to reduce hospital reimbursements and not specifically because of high readmissions. Why else would over 2,500 (or half of all US hospitals) be faced with readmission penalties in FY 2017 (Advisory Board).

 

Don’t be subject to these penalties. Here’s how HIPAA compliant videoconferencing can help.

According to a study conducted by UCSF, massive numbers of premature discharges and patient readmissions were a result of poor communication. In that study, 31% of readmission cases could have been prevented because some of those readmissions were due to: “inability of patients to keep follow-up appointments, lack of awareness of whom to contact if problems arose, [and] insufficient disease monitoring post-discharge.”

Using a HIPAA compliant videoconferencing system can reduce the amount of missed follow up appointments because patients can do them from anywhere (and easily) as it eliminates the hassles of commuting and waiting in line. In these follow up sessions the patient knows exactly who to contact and the provider stays up to date on the patient’s progress, keeping them from being readmitted. For more information about using a HIPAA compliant service, check us out at www.securevideo.com

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