Memo #1: Potential challenges on ACA
Readmission
Patient Safety Organization (PSO) was designated by the Affordable Care Act to assist Hospitals with relatively high readmission rates to reduce the number. Readmission is defined as an admission of a patient to the hospital within 30 days of the date of discharge. According to the Centers for Medicare & Medicaid Services (CMS), University Hospitals was on the list of high readmission rates, with an AMI of 21.8, HF of 26.6, and a total of 1328 of discharges. There are many resources available on reducing unnecessary hospital readmissions, for example, the ProjectRED, which “can reduce readmissions by integrating better communication among clinicians and patients and by instituting follow-ups after discharge” (CMS).
However, one important approach was to improve the transition process in inpatient and outpatient care for UH. By setting up a detailed and enforceable action plan to improve continuity of care, UH should focus on the following aspects: the compliance of national safety goals and regulations, the quality of transition approaches, the follow-up of regular reexamine, etc. These are not only methods to avoid high readmission rates, but also techniques to improve patient satisfaction and to reduce unnecessary administrative costs. Furthermore, another plausible approach is to bring closer relationship between hospitals and patient families, since they are an important part of patient satisfaction.
Pay-for-performance
Based on CMS. ACA established a value-based purchasing program, which was a quality incentive program built on the Hospital Inpatient Quality Reporting measure. The main idea of this program is to “reward hospitals for the quality of care they provide to Medicare patients, not just the quantity of procedures they perform” (CMS). CMS evaluates the effectiveness of hospital operation by