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NATIONAL HARBOR, MD. – It’s time for hospitalists to embrace affordability of care by concentrating on quality improvement, length of stay management, and efforts to reduce readmissions, said Dr. Shaun D. Frost, a hospitalist at Regions Hospital in St. Paul, Minn., at the annual meeting of the Society of Hospital Medicine.
Dr. Frost, associate medical director for care delivery systems for HealthPartners Health Plan, said that simultaneously targeting quality improvement and patient experience improvements often results in concatenated cost savings. Become familiar with the many quality and experience objectives of government programs such as the Centers for Medicare & Medicaid Service’s Hospital-Acquired Condition (HAC) Reduction Program and Hospital Value-Based Purchasing, he advised, to align quality and patient experience improvement efforts with payment reforms that aim to meet pay-for-value targets between hospitals and payers.
Taking that approach,“you stand to potentially double your financial return on your investment by driving unnecessary expenses out of the system and capitalizing on potential revenue opportunities that are associated with meeting these value-based improvement reimbursement targets,” Dr. Frost said during the meeting.
Dr. Frost gave the example of a structured process to assess discharge preparedness. The protocol should routinely include a patient risk assessment, patient education strategies focused on the adequacy of discharge instructions, a literacy assessment of patients, and postdischarge telephone calls, he said.
Another readmissions cost containment approach is that of hospitalist care transition services. For example, hospitalists can consider running a postdischarge follow-up clinic or an emergency department consultation service that focuses on patients who present to the ED soon after discharge. Home visits to at-risk patients by hospitalists are another consideration, he said.
Dr. Frost also emphasized the importance of implementing cost-containment measures surrounding length of stay management. Primary strategies in this area include efficient personal rounding strategies, daily multidisciplinary meetings, and rational use of consultation. Hospital medicine groups should strongly consider geographic provider placement by assigning hospitalists to select floors or wards within a hospital. He pointed to a 2014 study in the Journal of Hospital Medicine that found a geographic provider placement program at Emory University Hospital decreased in-hospital mortality from 2.3% to 1.1% and reduced length of stay from 5 to 4.5 days.
Analyzing patient data is also an effective avenue toward improving value and identifying cost strategies, added Kelly Logue, senior director of care affordability, hospital medicine, and critical care at HealthPartners. Data on high-risk patients as well as a list of discharge medications can help hospitalists develop unique care plans and educate patients about medication costs and optimal treatment, Ms. Logue said. She noted the value in predictive analysis and using patient data with census data to determine when patients in specific geographic areas may be in need of more customized patient care.
Sociogeographic approaches are one example of “getting ahead of the curve; not just focusing on what’s happening inside the hospital, but what is going on outside the hospital, and how hospitalists can really affect the changes that are coming to prevent patients from having an unnecessary admission.”
On Twitter @legal_med
NATIONAL HARBOR, MD. – It’s time for hospitalists to embrace affordability of care by concentrating on quality improvement, length of stay management, and efforts to reduce readmissions, said Dr. Shaun D. Frost, a hospitalist at Regions Hospital in St. Paul, Minn., at the annual meeting of the Society of Hospital Medicine.
Dr. Frost, associate medical director for care delivery systems for HealthPartners Health Plan, said that simultaneously targeting quality improvement and patient experience improvements often results in concatenated cost savings. Become familiar with the many quality and experience objectives of government programs such as the Centers for Medicare & Medicaid Service’s Hospital-Acquired Condition (HAC) Reduction Program and Hospital Value-Based Purchasing, he advised, to align quality and patient experience improvement efforts with payment reforms that aim to meet pay-for-value targets between hospitals and payers.
Taking that approach,“you stand to potentially double your financial return on your investment by driving unnecessary expenses out of the system and capitalizing on potential revenue opportunities that are associated with meeting these value-based improvement reimbursement targets,” Dr. Frost said during the meeting.
Dr. Frost gave the example of a structured process to assess discharge preparedness. The protocol should routinely include a patient risk assessment, patient education strategies focused on the adequacy of discharge instructions, a literacy assessment of patients, and postdischarge telephone calls, he said.
Another readmissions cost containment approach is that of hospitalist care transition services. For example, hospitalists can consider running a postdischarge follow-up clinic or an emergency department consultation service that focuses on patients who present to the ED soon after discharge. Home visits to at-risk patients by hospitalists are another consideration, he said.
Dr. Frost also emphasized the importance of implementing cost-containment measures surrounding length of stay management. Primary strategies in this area include efficient personal rounding strategies, daily multidisciplinary meetings, and rational use of consultation. Hospital medicine groups should strongly consider geographic provider placement by assigning hospitalists to select floors or wards within a hospital. He pointed to a 2014 study in the Journal of Hospital Medicine that found a geographic provider placement program at Emory University Hospital decreased in-hospital mortality from 2.3% to 1.1% and reduced length of stay from 5 to 4.5 days.
Analyzing patient data is also an effective avenue toward improving value and identifying cost strategies, added Kelly Logue, senior director of care affordability, hospital medicine, and critical care at HealthPartners. Data on high-risk patients as well as a list of discharge medications can help hospitalists develop unique care plans and educate patients about medication costs and optimal treatment, Ms. Logue said. She noted the value in predictive analysis and using patient data with census data to determine when patients in specific geographic areas may be in need of more customized patient care.
Sociogeographic approaches are one example of “getting ahead of the curve; not just focusing on what’s happening inside the hospital, but what is going on outside the hospital, and how hospitalists can really affect the changes that are coming to prevent patients from having an unnecessary admission.”
On Twitter @legal_med
NATIONAL HARBOR, MD. – It’s time for hospitalists to embrace affordability of care by concentrating on quality improvement, length of stay management, and efforts to reduce readmissions, said Dr. Shaun D. Frost, a hospitalist at Regions Hospital in St. Paul, Minn., at the annual meeting of the Society of Hospital Medicine.
Dr. Frost, associate medical director for care delivery systems for HealthPartners Health Plan, said that simultaneously targeting quality improvement and patient experience improvements often results in concatenated cost savings. Become familiar with the many quality and experience objectives of government programs such as the Centers for Medicare & Medicaid Service’s Hospital-Acquired Condition (HAC) Reduction Program and Hospital Value-Based Purchasing, he advised, to align quality and patient experience improvement efforts with payment reforms that aim to meet pay-for-value targets between hospitals and payers.
Taking that approach,“you stand to potentially double your financial return on your investment by driving unnecessary expenses out of the system and capitalizing on potential revenue opportunities that are associated with meeting these value-based improvement reimbursement targets,” Dr. Frost said during the meeting.
Dr. Frost gave the example of a structured process to assess discharge preparedness. The protocol should routinely include a patient risk assessment, patient education strategies focused on the adequacy of discharge instructions, a literacy assessment of patients, and postdischarge telephone calls, he said.
Another readmissions cost containment approach is that of hospitalist care transition services. For example, hospitalists can consider running a postdischarge follow-up clinic or an emergency department consultation service that focuses on patients who present to the ED soon after discharge. Home visits to at-risk patients by hospitalists are another consideration, he said.
Dr. Frost also emphasized the importance of implementing cost-containment measures surrounding length of stay management. Primary strategies in this area include efficient personal rounding strategies, daily multidisciplinary meetings, and rational use of consultation. Hospital medicine groups should strongly consider geographic provider placement by assigning hospitalists to select floors or wards within a hospital. He pointed to a 2014 study in the Journal of Hospital Medicine that found a geographic provider placement program at Emory University Hospital decreased in-hospital mortality from 2.3% to 1.1% and reduced length of stay from 5 to 4.5 days.
Analyzing patient data is also an effective avenue toward improving value and identifying cost strategies, added Kelly Logue, senior director of care affordability, hospital medicine, and critical care at HealthPartners. Data on high-risk patients as well as a list of discharge medications can help hospitalists develop unique care plans and educate patients about medication costs and optimal treatment, Ms. Logue said. She noted the value in predictive analysis and using patient data with census data to determine when patients in specific geographic areas may be in need of more customized patient care.
Sociogeographic approaches are one example of “getting ahead of the curve; not just focusing on what’s happening inside the hospital, but what is going on outside the hospital, and how hospitalists can really affect the changes that are coming to prevent patients from having an unnecessary admission.”
On Twitter @legal_med
AT HOSPITAL MEDICINE 15
