For Hospitals Facing $1.6BN in HCAHPS and Readmission Penalties, Analyzing Risk-per-Bed Provides Clarity
A recent CipherHealth study shows that many hospitals face disproportionate penalties for readmissions and HCAHPS, particularly when viewing penalties on a per-bed basis. The study calculated three-year at risk amounts of over $3,500 per inpatient bed at over five hundred hospitals across the country.
New York, NY (PRWEB) June 11, 2012
Governments work in macroeconomics. Legislation is created to targets industries, looking at state and national data to determine overall policy impact. Such was the case with ARRA (American Recovery and Reinvestment Act) and PPACA (Patient Protection and Affordable Care Act), legislation that created the Value Based Purchasing and Readmissions penalties for hospitals. These two bills were designed to help align hospital incentives around patient care, tying the successful recovery of a patient and that patient’s perception of the quality of the hospital to Medicare and Medicaid reimbursements. With 39% of hospitals running at a loss in 2011 , even a small change to these reimbursement rates can lead to huge changes in staffing models at hospitals, and ultimately the quality of patient care they are able to provide.
To understand the impact of the shifting reimbursement landscape and impending penalties, CipherHealth embarked on an in-depth study analyzing how the legislation would affect acute care hospitals. Using data from the American Hospital Association, Kaiser Family Foundation and CipherVoice patient surveys, the study found surprising results.
In states such as West Virginia, the statewide risk is quite low, ranking 32nd when compared to the rest of the nation on three-year at-risk totals for readmissions and HCAHPS. However, at $3,600, the average amount at risk per bed in West Virginia is among the highest state averages in the country.
“The risk per bed view is a much more effective way to look at the data. Thinking of penalties on a per-bed basis helps hospitals to prioritize the dozens of different pieces of legislation and focus on what will create the most value for their organization,” says Zachary Silverzweig, one of the founders of CipherHealth, a company that helps hospitals reduce preventable readmissions and improve satisfaction through better patient communication. “It’s why we we’re able to establish such a strong presence in West Virginia. We quickly realized there was a serious pain point and we were well positioned to deliver a solution to help hospitals avoid these penalties.”
In some states, the story is almost the exact opposite. California ranks second in terms of total at risk amount, yet ranks 30th when viewed on a risk-per-bed basis. Texas ranks fifth at the aggregate level, but on a per-bed basis ranks 32nd. However, when looking at the data for California and Texas at the health system level, there is wide variation. Tenet Healthcare, which has a presence in 11 states, has an amount at risk per bed of $2203 overall, but for its Texas facilities, amount at risk per bed is $1481. Other health systems such as East Texas Medical Center have a much higher amount at risk per bed at $4370.
The analysis also provides insight that defies geographic and demographic trends: North Dakota has a 70% higher at-bed risk than South Dakota and Mississippi has 51% higher average per-bed risk than neighboring Alabama.
With hospital executives facing everything from RAC audits to Value Based Purchasing to Meaningful Use to ICD10, it is critical to be able to prioritize the various hospital initiatives and focus on key projects that can drive both short and long-term ROI. Beyond direct returns, Silverzweig believes there is a much larger goal at stake.
“We believe that we offer a simple solution to help improve HCAHPS and prevent readmissions, but our true mission is to create a better line of communication between hospitals and their patients. Communication leads to happier, healthier patients. This is really the core of the patient experience portion of VBP and it’s part of the reason that the government moved forward with ARRA and PPACA legislation in the first place.”
About CipherHealth, LLC
Founded in New York in 2009, CipherHealth™ LLC provides improved care coordination and patient engagement through post discharge follow-up programs helping healthcare organizations reduce 30-day readmissions and increase patient satisfaction.
Requests for CipherHealth data and study information should be made to Zach Silverzweig (ZSilverzweig(at)cipherhealth(dot)com).
For the original version on PRWeb visit: http://www.prweb.com/releases/prweb2012/6/prweb9462994.htm