MGMT Hospital Inc is a private concern that recently opened it doors to the public in the suburbs amidst heavy traffic. There are hardly any quiet nights. Sirens are a constant feature. However, once inside, there is just the hustle and bustle of hospital staff going back and forth. A hospital readmission is when a patient who is discharged from the hospital, is re-admitted again within a certain period of time. Hospital readmission rates for certain conditions are now considered an indicator of hospital quality, and also affect the cost of care adversely. For this reason, Centers for Medicare & Medicaid Services established the Hospital Readmissions Reduction Program (HRRP) which aims to improve quality of care for patients and reduce health care spending by applying payment penalties to hospitals that have more than expected readmission rates for certain conditions. Although diabetes is not yet included in the penalty measures, the program is regularly adding new disease conditions to the list, now totaling 6 for FY2020. In 2014, Hospitals in surrounding cities spent over $41 billion on patients who were readmitted within 30 days of discharge. Being able to determine factors that lead to higher readmission in such patients, and correspondingly being able to predict which patients will get readmitted can help hospitals save millions of dollars while improving quality of care.
FROM THE PERSPECTIVE OF THE CHIEF INFORMATION OFFICER (CIO) OF THE IT DEPARTMENT PLEASE ANSWER QUESTION 1 & 2:
Taking the Hospital Readmissions Reduction Program (HRRP) into consideration, Discuss how MGMT Hospital Inc. can successfully implement this program, thereby reducing hospital readmissions, lower health care costs and improve patient safety and outcomes.
From the perspective of your department and management level, discuss the implications of participating in this program.
- Suggest ONE advantage and ONE disadvantage of implementing HRRP.
- Discuss ONE privacy issue that could arise with implementing HRRP.
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