Each year there are about 1 million hospitalizations for congestive heart failure (CHF) in the U.S. This means the healthcare system faces millions of dollars in extra care and lost Medicare reimbursements if those 83,000+ people a month return to the hospital with 30 days.
To track monthly CHF discharges, health systems need to keep tabs on a patient population roughly the size of Santa Monica, Calif. When the discharge flow is that immense, it’s hard to ensure high-quality care coordination. That’s where scheduling technology can help.
A 2013 Yale University study recommended six evidence-based practices for reducing CHF readmissions; one suggested scheduling follow-up appointments before patients get discharged. The study estimated that pre-discharge scheduling could help reduce CHF readmissions by up to 2 percent nationwide.
Trying to arrange these appointments by phone is expensive and time-consuming. But with scheduling software, it’s much easier to align hospital discharge flow with cardiology practices’ scheduling systems.
All stakeholders benefit from automated scheduling: patients have better outcomes, hospitals reduce readmission penalties, and physicians qualify for additional reimbursement for transitional care management (TCM). By the Department of Health and Human Services’ own estimates, TCM services can increase physicians’ Medicare reimbursements by around 4 percent – but these services must be provided within a tight timeframe.
To bill for moderate-complexity transitional care, physicians must document that they’ve communicated with the patient within two business days of discharge. They must also schedule a face-to-face visit within 14 calendar days. For high-complexity cases, the in-person visit must be within seven calendar days.
More conditions to monitor
Although CHF readmissions are slowly decreasing, CMS has widened its readmission reduction program to include COPD and elective hip/knee replacements. That’s why 78 percent of U.S. hospitals received readmission penalties last year, a significantly higher percentage than in the previous two years.
Trying to arrange post-discharge appointments by phone has now gotten even more frustrating and time-intensive. Imagine a discharge staffer playing phone tag not just with cardiology practices but with orthopedists and pulmonologists, too.
But with scheduling technology, a discharge staffer can book a follow-up appointment with ease, knowing that the slot has automatically been reserved in the practice’s scheduling system.
It’s been decades since people last tried to make an airline reservation the analog way – calling a travel agent with your list of preferred dates. Hospitals can no longer afford to arrange follow-up care using the telephone and a memo pad. The financial penalties for preventable readmissions are too severe to postpone what other industries adopted long ago: easy-to-use, online scheduling.
Tom Cox is CEO of MyHealthDirect in Nashville, Tenn.