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Hospitals Face Billions Of Dollars In Losses Due To ACA Readmissions Rules

Plantation, FL, Aug. 1, 2013 (GLOBE NEWSWIRE) -- To  help hospitals address the Hospital Readmission Reduction Program (HRRP) provision of the Affordable Healthcare Act, Health Revenue Assurance Holdings, Inc. (OTCBB: HRAA) has developed Readmissions Visualizer TM to improve and protect revenue by predicting which patients are at high risk for readmissions.

Readmissions Visualizer TM, currently being beta tested by multiple hospital systems, is a predictive modeling analytics solution.  The product focuses on readmission improvement metrics on high risk patients so hospitals can improve their readmissions profile. Hospital employees ranging from senior level administrators to care managers can utilize Readmissions Visualizer TM to identify trends in readmissions, flag patients that are at risk of being readmitted and prioritize action-oriented plans to reduce their likelihood of returning.

Under HHRP the Centers of Medicare and Medicaid (CMS) will fine hospitals for high rates of Medicaid patients -- treated for conditions that include heart failure and pneumonia -- who are readmitted within 30 days of being discharged. The program is expected to save CMS billions of dollars over the next seven years and put thousands of hospitals at financial risk if they do not curb rates.

"A typical hospital with 350 beds will lose between $2.5 and $3 million over three years if they have a poor readmissions rate. We know, from years of working with more than 900 hospitals, which key indicators improve predictions that a patient is at high risk of readmission. These risk factors include poor support systems in the home, prescription medication payment concerns, accessibility of health services and other social and economic data," said Michael Gallagher, MD, chief medical officer of HRAA.

Readmissions Visualizer TM provides hospitals with the ability to view current inpatient and historical readmission information through an intuitive Web interface. Key features include:

  • Readmission Dashboard - View of monthly Readmission Results for HF, AMI, Pneumonia, and COPD with patient detail by Practice or Provider.
  • Near -Miss Analysis- View of Emergency Room, Urgent Care and Observation Status to reveal gaps and indicate processes that can be improved.
  • Current Risk - View of  current census including Read for Admission, History of CHF/AMI/PN, Readmission Risk Score, Emergency Room History, and Follow-Up Appointments.

"In order to impact readmissions of Medicare patients, hospitals need a way to monitor their performance," continued Dr. Gallagher. "CMS penalties will hurt, and every dollar a hospital loses threatens their ability to provide quality healthcare services to patients."

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