Every hospital in the United States is seeking ways to prevent patients from bouncing back to the acute care floor after discharge. Historically, providers have sought to send patients home with home care or transfer them to a skilled nursing facility. Recent increase in payment denials for post-acute care makes this strategy more difficult. Issues of patients living alone and those in remote locations further impede traditional outreach strategies to reduce readmission.
The new models of Transitional Care consistently yield reduced rates of readmission. By targeting the patient population most at risk for readmission, patients can be transferred to an alternative venue of care before returning home. These alternative venues of care may not necessarily be independently reimbursable for this type of service by traditional or Federal payors. Supportive services in either a medical or non-medical environment are designed to monitor the patient’s health status and wellbeing. Through patient monitoring, medication management, assistance with daily life activities, care coordination, and patient education—patients readmission rates plummet.
The hospital and the community-based provider often enter into collaborative agreements to operate the TCM. While the hospital providers reduce readmission penalties, the community partner is often payed for underutilized space and staff. Of course, state licensure laws and Federal Medicare Certification requirements as well as unique provider circumstances dictate the exact nature of each collaborative agreement. Advis provides assistance in designing such collaboration agreements and conducts feasibility studies to determine operating costs, reimbursement rates, and program ROI.
Contact Advis for more information or call our offices at (708) 478-7030.