In last week's post, we reviewed the risk for not reporting to the various regulatory reporting programs. Today we're going to take a closer look at what it means to get hit with a penalty from one particular program: The Hospital-Acquired Condition (HAC) program.

Imagine your health care organization is challenged with excess readmissions to the hospital. Suddenly, you find yourself on a vendor selection team to evaluate predictive analytics that will help your care management team be more proactive in transition of care planning for your patients. 

While it may seem like a daunting task, assessing your hospital's profitability can help you streamline operations and work toward improved financial outcomes. And with rising regulatory reporting costs and the risk of government penalties, knowing where your organization stands financially is crucial. But how do you go about getting an accurate depiction of your hospital costs? 

Implementing a case costing solution is a great way to better price the products and services that your organization provides while identifying areas for cost savings. So, to help you get started with your case costing journey, we've highlighted three common hospital case costing methodologies in the infographic below. 

Did you know that a whopping 751 hospitals were penalized for their high Hospital-Acquired Condition (HAC) rates this year?

The HAC program is one of the CMS programs that can hit hospitals with a penalty and significant revenue loss. And this year, the HAC scores look a little different than they have in years past. Before we share which states landed on the list of the worst HAC performers, let’s dive into how the HAC program works and what it means to get a HAC penalty.

Did you know that almost 80% of hospitals nationwide received a penalty to their Medicare reimbursement payments in 2018 due to their hospital’s readmission rate?¹ Hospital readmission rates continue to be a problem in our country. However, there are tools that hospitals can leverage to help them predict the likelihood of a patient coming back into their hospital. Using this predictive tool, Medisolv created a handy Readmission Prevention Checklist—and you can download it for free! The checklist will help your hospital get started on a plan to intervene with your high-risk inpatients.

Are any of these value-based purchasing programs actually working? Well a safe answer may be, "perhaps." On any given day you could find these two contrasting headlines:

"CMS program to reduce hospital-acquired conditions has flaws"

"HHS: Patient Safety Efforts Save 125K Lives, $28B in Spending"

The thing is, both are true. According to the National Scorecard on Rates of Hospital-Acquired Conditions 2010 to 2015, Hospital-Acquired Conditions (HACs) have shown a 21% decrease across that time span. And yet every year when CMS releases the list of hospitals penalized for their HAC scores, we see that there are still many hospitals across the country still struggling with controlling their HACs.

Shrinking hospital margins headline much of the health care news these days. But how do you know if your margins are shrinking if you aren’t sure what your costs are?

In order to assess the profitability of your hospital, you must know what your hospital costs are.

In this infographic, we have highlighted three common Hospital case costing methodologies.

It’s 7 p.m. and you’ve just been in an accident. Nothing serious, but you think your ankle is sprained. You decide to go to the emergency room. Upon entering the ER, you see EMTs wheeling in patients on gurneys with oxygen. As you continue into the waiting room, you hear someone mention a multicar accident. You look around for a seat, but the waiting room is crowded. As a stable patient, you might be in for a long wait.

It’s no secret that longer emergency room waiting times can lead to worse patient outcomes and lower patient satisfaction scores. In this critical department of the hospital, each moment can mean the difference in the life of the patient.

The current state of Medicare readmission penalties 

In this blog, we explore how hospitals are using predictive analytics to determine at-risk patients. We consider how the risk assessment tool can lower a hospital's readmission rates.

This year, a staggering 77% of hospitals will receive some percentage of penalty to their 2016 funding under Medicare’s Readmissions Reduction Program.