The Centers for Medicare and Medicaid Services (CMS) now penalizes hospitals for excess readmissions with up to a three percent payment reduction. For many health systems, this can translate into millions of dollars. In fact, just one or two excess readmissions in populations such as Acute MI, Heart Failure, Pneumonia, COPD, Total Hip and Knee Replacements, and Coronary Artery Bypass Surgery can tip a hospital over its allowable readmission rate.
Do you know what your tipping point is?
Leveraging advanced analytics, we replicate CMS’s readmission risk models and penalty calculations to provide a proactive view of your performance considering readmissions, within your network and other area hospitals, up to three years before you receive your excess readmission reports from CMS. This data delivers predictive insights, providing estimates of your hospital’s expected financial penalties for two and three fiscal years into the future. This allows you to prioritize your hospital readmission reduction strategies today for those clinical populations with the greatest risk for financial penalties tomorrow.
Conduent’s advanced analytics solution provides:
- Quarterly delivery of performance results at System, Individual Facility, and Individual Clinical Cohort levels
- Advice for performance improvement in clinical outcomes and associated penalties
- Five years of Medicare data linked to your patients in Midas+ solutions to proactively replicate CMS risk models
- Adjusted readmission rates to account for readmissions to different hospitals
- Availability of predicted and expected readmission rates for your hospital up to three years before CMS provides hospital-specific reports
- Prioritization of clinical cohorts by greatest risk for financial penalty and greatest opportunity for improvement
- Patient-level risk coefficients to drive quality improvement across your organization
- Insights from a Midas+ executive wrapped around predictive analytics to bring to light areas of concern and potential opportunities for targeted improvement strategies