CMS' readmission penalties rolled out this month with hospitals facing a penalty cap of 1 percent of their Medicare revenue this fiscal year. The penalty will increase to 2 percent in FY 14 and 3 percent in FY 15. Hospitals may also be subject to additional conditions for the penalty beyond the initial heart attack, heart failure and pneumonia DRGs.
Hospitals are making the transition from the mindset that every readmission is revenue to every readmission is a penalty and developing collaborative strategies with the post-acute providers in their communities to ensure the transition out of the hospital and the reception into the next site of care is a successful one.
During Readmission Penalties in 2013: A Cross-Continuum Approach To Lessen the Financial Impact, a November 14th, 2012 webinar, now available for replay, Amy Boutwell, MD, MPP, president of Collaborative Healthcare Strategies, co-founder of the STAAR (State Action on Avoidable Rehospitalizations) Initiative of the Institute for Healthcare Improvement (IHI) and senior physician consultant to the National Coordinating Center for the CMS QIO Care Transitions Theme, shares cross-continuum strategies and tactics to reduce readmissions and lessen the financial impact of the Readmission Penalty program.
Dr. Boutwell covers:
- Creating a diversified and stratified approach to reducing readmissions;
- Developing a practice change culture to respond to clinical conditions that ensures patients are treated at the right site of care;
- Reviewing care processes, readmissions and enabling testing and implementing practice improvements to reduce readmissions; and
- Making the improvements needed in reducing readmission while incurring penalties.
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Presidents/CEOs, CFOs, chief operating officers, vice presidents, medical directors, reimbursement executives, analysts, business development executives, consultants, directors, executive directors, financial/business managers, and strategic planning executives.
ABOUT OUR PANELIST:
Amy Boutwell, M.D., M.P.P., founded Collaborative Healthcare Strategies to pursue work aligned with the opportunities created by the Affordable Care Act, the CMS Center for Innovation and the Partnership for Patients, specifically with the goal of engaging thousands of communities across the nation to work across settings and sectors to improve healthcare delivery. With the creation of Collaborative Healthcare Strategies, Dr. Boutwell works at the intersection of all best practices and approaches to improve care transitions, without exclusive adherence to one particular model taking the best from what is known to be effective, practical and efficient in improving care transitions.
Dr. Boutwell is the co-founder of the STAAR (State Action on Avoidable Rehospitalizations) Initiative of the Institute for Healthcare Improvement (IHI). Since 2008, Dr. Boutwell has been deeply immersed in the clinical, operational, policy, payment and political aspects of approaches to reduce avoidable rehospitalizations and improve care transitions. The STAAR initiative currently engages over 150 hospitals in four states, over 500 community providers through cross-continuum teams and over 75 state-level public and private-sector leadership entities through state steering committees. In her former role as the co-principal investigator of the $5 million STAAR grant at IHI, Dr. Boutwell was responsible for the state strategy, policy, clinical integrity and thought leadership for the program. As a result of her work, Dr. Boutwell has served as an expert panelist or advisor to CMS, the National Governors Association, and the Academy Health State Quality Improvement Institute.
Dr. Boutwell serves as a senior physician consultant to the National Coordinating Center for the CMS QIO Care Transitions Theme and is thus engaged in community-based care transitions mobilization efforts in all 50 states. Additionally, Dr. Boutwell is co-leading an AHRQ-funded effort to test and adapt best practices to improve transitions to ensure applicability to the Medicaid/safety-net population. Dr Boutwell was a founding board member of the Long Term Quality Alliance, and co-chaired the development of the Long Term Quality Alliances Innovative Communities Initiative. She is an active advisor to health systems in the United Kingdom and the United States on designing and /or updating strategies to improve care across settings and reduce avoidable rehospitalizations.
Dr. Boutwell is a graduate of Stanford University, Brown University School of Medicine and the Harvard Kennedy School of Government, where she received a masters degree in public policy and the Robert F. Kennedy Award for Excellence in Public Service. Dr. Boutwell is a practicing physician at Newton-Wellesley Hospital, attends on the medicine teaching service at Massachusetts General Hospital and is an Instructor in medicine at Harvard Medical School.
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