Case Management

Hospital Readmissions Reduction Program for Quality, Case Management, and CDI - Live webcast

Case Management Insider, September 29, 2015

P4P programs such as the Hospital Readmissions Reduction Program (HRRP) link the payment hospitals receive to performance for defined quality measures. The HRRP reduces payments by up to 3% for hospitals with “excess readmissions.”

CMS determines each hospital’s excess readmission ratio using claims-based data; assigned ICD-9-CM (soon to be ICD-10) codes have a direct impact on this calculation. If the hospital’s predicted readmission rate exceeds the expected readmission rate, the hospital will receive a financial penalty. The quality of claims data is therefore extremely important, influencing not only what discharges are included in the program but the excess readmission ratio. Examples of claims data that impact program measure performance include the principal diagnosis, secondary diagnoses, and discharge disposition.

During this program, our expert speaker Shannon Newell, RHIA, CCS, AHIMA-Approved ICD-10-CM/PCS Trainer, will:

  • Promote an understanding of the HRRP, including the methodologies used to select discharges for consideration in the measure and to perform risk adjustment
  • Review key updates included with the FY 2016 IPPS final rule
  • Examine one of the populations included in the measure to demonstrate the impact of data quality and collaboration opportunities between quality, case management, and the CDI program

For more information or to order, call 800/650-6787 and mention Source Code EZINEAD or visit the HCPro Healthcare Marketplace.

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