I recently attended a CFO panel discussion of three local hospitals. The purpose of the event was to learn how we, as members of a local health council, can work hand in hand with these hospitals as they move into uncertainty around healthcare reform, growing patient needs, aging populations and budget controls.
They are trying to prepare and position themselves to be successful while still delivering a high level of patient care. Normally my communication is with the end users of our service or department managers so it was very nice and informative to hear the prospective of health care from the CFO or accounting side of the business. Several messages came across loud and clear today:
- The hospitals know to be successful they have to collaborate, not only within their own systems but across systems, with their competitors
- Patients will be in the hospital fewer days and moved to Acute or Rehabilitation Care facilities
- Their rates from Medicare and Medicaid are not going up
- The number of patients in the Medicare and Medicaid system will grow by 20% to 30%
- Physicians are no longer working independently they want to be part of a system
- They have to reduce Bounce Back patients to avoid penalties from Medicare and Medicaid
Bounce Back patients, what does that mean?
It is a patient that has had a procedure or a visit to the doctor, has been discharged with a care plan and the plan is not followed or understood. This results in the patient returning to the facility due to not following through, not understanding how to do something correctly which may be jeopardizing their recovery. This is a bounce back patient and they cost a medical facility money and extensive resources. Ideally, this patient should not require additional support, however, they come back to be seen possibly numerous times. The bigger concern that healthcare facilities are facing is the penalties that will come from Medicare and Medicaid for these patients.
When I asked if they had a communication plan in place for the patient at discharge, there was not much response other than “we rely on scripting and the use of patient navigators to help the patient.” Basically, they have not created a plan to ensure these patients understand what to do or not do once they are home. This was a little mind blowing to me.
There is no process or plan for the following steps in patient care:
- How are the facilities going to be required to push more patients through the system?
- How are they managing less face time with the doctor?
- What are they doing to reduce the bounce back visit for that patient?
This is key since there is a direct repercussion for the facilities lack of planning. Medicare/Medicaid has told them there will be additional dollars lost for these patients. You would think this would be a motivator to create a plan of action.
As I listened to these three CFOs talk about collaboration and working together, I would like to apply that same sharing spirit in my post this week. I encourage your feedback and input as to what is working for your facility. As I talk to my clients this will become an important new topic of discussion, learning what is working for them and what is needed from us to be more successful in reducing their bounce back patients. I look forward to hearing your feedback and sharing what I learn with you!