Hospital Readmission Reduction

This program is built specifically to assist hospitals manage Medicare patients who are at risk for readmission and avoid the IPPS base-operating DRG payment reduction penalty authorized under the Affordable Care Act. Highly automated, yet supremely flexible, PowerObjects’ Discharge Readmission Evaluation and Management (DREAM) solution provides a highly cost-effective mechanism to reduce acute myocardial infarction (AMI), heart failure (HF) and pneumonia (PN) readmissions within the target 30 day period post-discharge.

Affordable Care Act Makes Hospital Readmission Reduction for Medicare Beneficiaries a Pressing Concern

Today, almost 20% of Medicare beneficiaries are readmitted to the hospital within 30 days of discharge. While this readmission rate was not a high concern in the past, new rules in the Affordable Care Act—specifically the Hospital Readmission Reduction Plan (HRRP)—state that hospitals that exceed a percentage of readmissions for heart attacks, heart failure, and pneumonia will face steep financial penalties. And beginning in 2015, even more conditions could be added to the list.

Complicating the situation, hospitals will not be financially rewarded for improving their admission rates—they will only be punished if they don’t. Hospitals could see reimbursements cut by 1-3% for all base operating DRG payments for these conditions for the next year. HRRP is expected to reduce payments to hospitals by $7.1 billion from 2013-2019.

The question is: How will hospitals lower their readmission rates for Medicare beneficiaries without an allowance to do so?

The Discharge Readmission Evaluation and Management (DREAM) Solution

PowerObjects has developed a solution on the Microsoft Dynamics CRM platform that automates low-cost mass intervention by identifying those patients who are at very high risk, and making sure patients follow through on intervention when needed. We call it the Discharge Readmission Evaluation and Management (DREAM) solution.

This low-cost, high impact solution was designed with the help of a medical advisory board to improve patient post-discharge recovery and reduce readmission rates. This helps institutions avoid debilitating DRG payment penalties. It does this by:

  • Importing target patient details into the system

  • Adding caregivers and family members as potential contacts to receive information and reminders

  • Sending reminders to visit the primary care provider and fill prescriptions

  • Sending documents that specify what to do during recovery

  • Identifying patients and/or family who are not accessing information

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What do you get with PowerObjects as your CRM partner?

PowerObjects uses a variety of inherent Dynamics CRM functions, as well as proprietary PowerPack add-ons, to accomplish these functions, including email, texts, automated task generation, robo-calls, and integration with existing hospital systems.