Jeffrey Rakover, Cardiovascular Roundtable
Many institutions still struggle with increased pressure to bill traditionally inpatient care on an outpatient basis. The RAC audit program continues to be controversial in some quarters, even if it’s accepted as an unfortunate fact of life in others.
The most recent proposed inpatient rule only exacerbates the pressure to accurately triage patients between inpatient and outpatient, proposing that patients be in the hospital for at least two midnights to qualify as true inpatients.
The Roundtable has produced a number of resources bearing on the question of increased scrutiny of inpatient stays and the shift toward outpatient payment. Here, we’ve compiled our tools and publications for programs to effectively navigate these pressures.
The resources include triage criteria, case studies and insights to optimize observation status, and strategies to decrease length of stay for procedures where actual care patterns lag behind payment categorization.
Managing the outpatient shift: Roundtable resources
Nicole MacMillan, Cardiovascular Roundtable
In late April, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), and the American Medical Association- Physician Consortium for Performance Improvement (AMA- PCPI) released an updated set of performance measures for heart failure management. The measures, an update of the 2005 ACC/ AHA HF performance measures, place an increased emphasis on coordinated, cross-continuum care, while eight past measures deemed redundant and no longer useful were retired. Of the nine total measures, two are focused on the inpatient setting, five on the outpatient setting, and two bridge both settings.
2011 HF management performance measures stress cross-continuum coordination
Citing a need for more clear process explanation for cardiovascular catheterization labs, leaders from prominent cardiology departments across the country have united to develop a consensus statement on best practices for the cath lab, published in this month’s Catheterization and Cardiovascular Interventions. The groups recommendations span the full scope of the process, from credentialing and team composition, to most effectively managing pre-,peri-, and post-operative procedures.
Cardiology leaders release cath lab best practice consensus statement