State of the Union recap: Light on health care mentions—but not implications

 

Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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The future of the two-midnight rule

by Jeffrey Rakover July 9, 2014

Wondering what's in store for two-midnight? Looking for guidance on implementation? Then you'll want to check out a recent post from our colleagues at the Care Transformation Center. 

Our two-midnight experts responded to three frequently asked questions of late: 

1. What are the implications of CMS’s recent request for comments on potential short stays payment methodologies?
2. How likely is an adjustment to the 0.2% cut in payment that accompanied the initial finalization of the two-midnight rule?
3. Should I focus on compliance right now?

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The case for palliative care

May 1, 2014

Olivia Ley, Cardiovascular Roundtable

CV programs are starting to embrace palliative care as a means to improve quality and reduce costs—and they’re backed by some compelling evidence.

We've reviewed some of this research below, and offered guidance to help you integrate these services into your care continuum strategy.

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Findings from ACC 2014—and the resources you need to act on them

April 24, 2014

Andrew Hresko, Cardiovascular Roundtable

At the end of March, two of my colleagues from the Service Line Strategy Advisor program attended the American College of Cardiology’s annual meeting in Washington, D.C. They’ve written several blog posts about what was discussed, including the promising future for transcatheter aortic valve replacement (TAVR) efficiency and length of stay, the need for further investigation of renal denervation, the learning curve for radial PCI, and the future of aortic aneurysm care.

To help you act on findings from the conference, I’ve highlighted the Cardiovascular Roundtable’s available resources on a few of these topics.

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CV service distribution: The decision aids you need

April 7, 2014

Olivia Ley, Cardiovascular Roundtable

More and more CV leaders have to make challenging decisions about how to distribute services across sites. This not only means thinking more strategically about where and when to offer new services, but, in some cases, when it’s necessary to consolidate programs.

And while these decisions will never be easy, you have resources at your disposal that make them easier.

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One way to make discharge education stick: Group discharge sessions

March 19, 2014

Andrew Hresko, Cardiovascular Roundtable

CV leaders know that post-discharge self-management plans are crucial to avoiding readmissions. For more than a decade, studies have shown that discharge planning can reduce readmission risk for heart failure (HF) patients. But these plans are only effective when patients are willing and able to comply.

To make sure patients can adhere to these directions, programs must provide thorough education on self-management skills. However, education often becomes a “cram session” that occurs shortly before discharge, when patients and family are anxious and less able to process complex instructions.

Fortunately, you don’t need to revamp your entire discharge planning approach to make instructions stick. CV leaders at South Nassau Communities Hospital in Oceanside, N.Y., supplement traditional one-on-one bedside delivery with group HF education sessions.

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How to track performance under risk-based contracts

February 28, 2014

Jeffrey Rakover, Cardiovascular Roundtable

As more and more CV providers take on risk-based payment, you need to start thinking about how to track performance against these contracts. The challenge is selecting metrics that you can use across payers, contracts, and time—particularly during and after the hospital stay. While providers can’t necessarily change conflicting reporting responsibilities in the near term, they can select high-value metrics to drive overall success.

Fortunately, you have some great examples to follow. Sparks Health and Maine Heart both saw significant performance improvement after updating their dashboards of CV performance metrics, specifically in the context of bundled payment models. Here’s a look at what they include.

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How the two-midnight rule will affect your hospital

February 19, 2014

Eric Fontana, Practice Manager

CMS recently announced that it will extend the two-midnight related “probe-and-educate” period. While this sounds like a risk-free educational period, Medicare Administrative Contractors (MACs) will still be actively auditing and denying claims until September 30, 2014. So while the probe-and-educate period offers an opportunity to get up-to-speed on the rule with less RAC scrutiny, this isn’t an opportunity to sit idle.

To help you understand the potential impact of this rule on your hospital, our team has prepared custom two-midnight impact assessments for all hospitals paid under Medicare’s IPPS. These institution-specific analyses show services “at risk” of moving from inpatient to outpatient and, conversely, long-stay observation cases that may be eligible for admission as inpatients.

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What’s the relationship between surgical volumes, costs, and quality in CV?

February 10, 2014

Olivia Ley, Cardiovascular Roundtable

Many researchers have investigated the relationship between surgical volumes, patient outcomes, and operation expenses. Their findings are increasingly important for today’s providers, who are under pressure to deliver higher-quality care at lower costs. So what’s the consensus?

We’ve examined some of the top research on this subject—and by and large, it suggests that higher volumes are associated with lower costs and better quality.

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