The ability to measure the impact of your investment is vital when investing in a new solution. The CMS Readmissions Reduction Program was legislated under the Affordable Care Act. This program launched in October 2012 and the 1% penalty on 30-day readmissions suddenly became a powerful pain point. In total, 2,217 hospitals will receive penalties ranging from .01% to 1% of total Medicare reimbursement generated during 2012. That percent will increase in the years 2013 and 2014.
Looking Under the Hood
The readmission penalty is complex. Let us provide you with a sample scenario:
- Total Licensed Beds: 500
- Annual Medicare Admissions: 10,000
- AMI, CHF and Pneumonia Medicare Admissions: 1,000
- AMI, CHF, Pneumonia 30-day Readmissions 230, Expected 200
- Payment Rate per Readmission: $10,000
- Cost Related to Excess Readmissions: $300,000
- Penalty (1 / national readmission rate): 5
- Annual Penalty: $1,5000,000
These penalties will recoup CMS $280 million alone in the year 2013. The penalties will increase over the next two years and the scope of diagnosis are set to expand to include COPD, Orthopedic Surgeries, etc.
What differentiates Medexi from other companies? We’re high tech, high touch! While our software serves as an early warning system for high-risk readmission, we also bridge with patients into their home within 24 hours of discharge. Our Transitional Care Providers visit with the patients in-home to provide eduction, compliance and follow up. If your hospital already has a transitional care team in place, then Medexi is the intelligence you need to rally those teams around patients who meet transitional criteria.
The Medexi ROI
When you redirect 30 readmissions you’ve paid for Medexi for an entire year! To put this number into perspective, last month our transitional care providers reduced a facilities readmission rate by 28%, thus the Medexi ROI was completed within 30 days. Furthermore, hospital systems receive enormous return in network referral revenue, decreased administrative costs, decreased faxing, less test redundancy and improved operation efficiency.
The Bottom Line
Healthcare systems in the future will be judged and penalized based on care coordination and patient satisfaction scores. Medexi 360 is completely vendor-neutral which has the ability to work with all systems and requires no installation within the hospital. To learn more about how Medexi can help your organization, contact us for a free demo.