Source:  Fierce Healthcare

A recent article from Fierce Healthcare highlights how one healthcare system uses a team approach toward reducing denials.  The case study examines a three-hospital healthcare system that had a dramatic improvement in results from 2008 to 2010 after implementing effective team approach steps.

Here are the highlights:

2008

• 77 days in accounts receivable on average
• Low cash on hand
• 99% percent of the hospital’s claims rejected on the first try

2010

• 37 days in accounts receivable on average
• Tripled cash on hand
• 3% denied claims on first try

Some of the steps they took to achieve these results:

• Counting errors
• Tweaking health information system
• Adding new scrubbing software
• Training revenue-cycle staff
• Educating the clinical team

For details of this remarkable case study visit Fierce Healthcare: Revenue-cycle case study: Reducing denials requires team approach

What steps does your healthcare organization take to help reduce denials?
Include your response in the “Leave a Reply” section.

Source: Agency for Healthcare Research and Quality

A new report from the Agency for Healthcare Research and Quality finds that, “About 40 percent of patients who sought acute hospital care from 2006–2007… made multiple visits to the hospital, for an IP stay or ED visit, during the two-year period.”

The AHRQ study is unique because, “Most readmission studies only report information on patients who have multiple hospital IP stays; they exclude patients who sought care in the ED. “  This study includes, “patients who accessed hospital care in either or both acute care settings (IP and/or ED) over the two-year period.” By including this group the AHRQ study found an “increased rate of multiple visits by more than a third” of patients; ranging “from an average of 1.5 to 2.1 acute care hospital visits per patient.”

Report Highlights:

• Two out of every five patients who sought acute hospital care (either an inpatient stay or an emergency department visit) from 2006–2007 in the selected states made multiple visits to the hospital during the two-year period.
• More than a quarter of patients with an inpatient (IP) hospital stay in 2006–2007 in the selected states had multiple inpatient hospitalizations during the two-year period.
• Factoring in ED visits increased the rate of multiple visits by more than a third, from an average of 1.5 IP readmissions to 2.1 hospital visits per patient.
• Medicare patients had the highest IP readmission rates (1.9 visits per Medicare patient) while Medicaid patients had the highest ED revisit rates (2.5 visits per Medicaid patient).
• Looking across both IP and ED settings, patients living in the poorest communities had 26.5 percent higher hospital revisit rates compared to patients from the wealthiest areas: 2.2 versus 1.8 visits per patient, respectively.
• Accounting for ED visits increased the percentage of patients seeking repeat hospital care for asthma (31.3 percent increase), uncomplicated diabetes (22.8 percent increase) and high blood pressure (20.9 percent increase).

Click this link from the AHRQ to view the complete 10 Page PDF report at:
Hospital Readmissions and Multiple Emergency Department Visits

Source: Boston University Medical Center

Of the $1.2 trillion leaking out of the healthcare system, PricewaterhouseCoopers Consulting reports that hospital readmissions rank as the #5 reason, at a cost of  $25 billion.  Helping the hospital discharge process may help to curb these figures.  Boston University Medical Center has developed Project RED to tackle the problems associated with hospital discharge.

Project Re-Engineered Discharge is a research group at Boston University Medical Center that develops and tests strategies to improve the hospital discharge process in a way that promotes patient safety and reduces re-hospitalization rates.  The RED (re-engineered discharge) intervention is founded on 11 discrete, mutually reinforcing components and has been proven to reduce rehospitalizations and yields high rates of patient satisfaction.  Virtual patient advocates are currently being tested in conjunction with the RED.  In addition, Project RED has started to implement the re-engineered discharge at other hospitals serving diverse patient populations.

Read more about the initiative at: Project RED (Re-Engineered Discharge)