Medicare Readmissions

Decent Essays

Chapter 2: Literature Review This project will focus on a hospital located in the upper Midwest. The focus of the project will be on Medicare readmissions at Henry Ford West Bloomfield Hospital (HFWBH). .
The Hospital Readmissions Reduction Program (HRRP) was passed in 2012 under the Affordable Care Act, to help hospitals to improve patient care and reduce costs. (Danner, 2016). The diagnoses with the highest readmissions rates associated with the highest expense are: acute myocardial infarction (AMI), pneumonia, and congestive heart failure. CMS also extended their program in 2015 to incorporate reimbursement reduction for hip/knee replacements, Chronic Obstructive Pulmonary Disease (COPD), and they also have plans in 2017 to include the …show more content…

Nurses help organize and manage patient’s transition to home whereas the pharmacist calls the patient after discharge to review their medications. Any problems with medications are communicated to the primary provider.
• Transitional Care Mode (TCM) –this program is for elderly that are high-risk for readmissions, such as patients who experienced heart failure or a heart attack or has chronic conditions. Advance practice nurses do home visits for these patients for three months, and are the nurses are available by phone seven days a week.
• Project BOOST (Better Outcomes or Older Adults through Safe Transitions)- hospital and primary care providers delivers a toolkit to improve care transition. The BOOST tools are follow up telephone calls, follow up appointments, interprofessional rounds (communication among care team during hospitalization and discharge), post-Acute Care Transitions, and medication reconciliation.
• State Action on Avoidable Readmissions (STAAR) – this is a pilot program to improve care transition that concentrates on developing community-based and state-based …show more content…

However, there are still some interface issues between Allscripts and Epic. Interfacing between two different EHR systems is vital for communication, accuracy, and efficiency. It requires customization of interoperability methodologies to overcome the constraints that prevent information flowing from one EHR to another.
System Interfaces HFHS utilizes both Allscripts and Epic for their EHR systems. In order to create a meaningful readmission report, information must be collected and collated manually. This results in questionably accuracy of the report as provided in feedback from various department. This project revolves around creating the electronic interfaces that would result in an automatically generated readmission report. It will involve and benefit stakeholders

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