How Hospitals Can Increase Medicare Reimbursements

Apr 07, 2017

hospital finances

Doctors continue to view patients as patients, but the Centers for Medicare and Medicaid Services (CMS) has shifted over the years to view them as paying customers. While a patient's main concern is the outcome of their treatment (i.e. has their health improved?), customers are more concerned with the overall process (i.e. were they satisfied with their stay at the hospital?).

CMS now puts a lot of emphasis on factors other than treatment outcome when distributing Medicare reimbursements, and it is costing hospitals billions of dollars each year. These factors include customer satisfaction (particularly HCAHPS scores) and readmission rates. In order to get the maximum amount of reimbursements from CMS, hospitals must take the initiative to drive up satisfaction rates while keeping readmission rates low.

Improving Patient Experience

In order to balance patient satisfaction and health, hospitals must make the patient the center of everything that they do. The goal should be to provide patients with as much information about the treatment process as possible. From pre-treatment education to consistent engagement throughout, hospitals must make patients feel that they are up to speed with everything that is being done to help them.

Patient perception of care is almost as important as its effectiveness. While a hospital stay is often uncomfortable, stressful and hard to cope with, patients are far more receptive to treatment when they fully understand why it's necessary, what side effects they may encounter and the eventual outcome they can expect.

Studies have shown that up to 80% of patients believe hospital whiteboards are an effective coping tool during the treatment process. To learn more about how patient whiteboards can be implemented into the treatment process, download our healthcare information booklet.

Taking Steps to Reduce Readmission Rates During Treatment

In studying the root causes of readmission, it's clear that communication plays a large role in driving down readmission rates. Many readmissions occur when patients do not understand their discharge goals, who to contact if they have questions and what constitutes a legitimate concern with their condition after discharge.

All in all, up to 25% of readmissions can be attributed to communication errors, which is using patient whiteboards as communication aids is an effective solution. When whiteboards are used in conjunction with treatment, patients are more likely to retain information presented to them.

Whiteboards can also be used in the nursing station to help coordinate tasks for care team members. When care teams become overloaded with patients, it can become difficult to ensure that every patient is receiving proper discharge instructions. Keeping track of who is responsible for relaying information to each patient is invaluable when multiple nurses have been in contact with a single patient.

Curbing Readmission Rates After Discharge

While preventing readmissions starts with proper patient care and thorough discharge instructions, steps must also be taken after discharge to ensure that patients are not unnecessarily readmitted.

Doctors can address patient questions and concerns during scheduled follow-up appointments, but there is generally a significant amount of time between appointments and hospital resources are limited. Care teams do not have the time to devote to patients who require frequent face-to-face time.

A solution to this problem has been found in telecommunications technology. A study conducted by Geisinger Health Plan (GHP) found that implementing Interactive Voice Response (IVR) systems made significant reductions in the probability of 30-day and 90-day readmission rates. The systems set up an automated line that patients call and answer questions to assess their physical condition, only readmitting them when certain symptoms were found.