Awarding Value-Based Payments
As a part of the value-base care initiative, participating practices were able to reduce emergency room re-admission costs by 16.4%. In order to receive a shared savings reward, the organization had to meet the following clinical targets for qualified Medicare patients:
- Have fewer hospital re-admissions within 30 days of discharge
- Have follow-up contact from their provider within 48 hours of a hospital admission, hospital discharge, or emergency department visit
- Have their medications identified by their provider within 48 hours of discharge from the hospital
- Have their preferences documented by their provider
- Use inpatient hospital and emergency department services less for conditions such as diabetes, high blood pressure, asthma, pneumonia, or urinary tract infection.
Today's house calls can include portable MRI machines for imaging as well as on-the-spot blood draws and testing, which enable clinicians to gauge the health of especially frail patients more closely. For a vulnerable Medicaid patient who is just out of the hospital, being able to remain at home, and not risk travel or hospital acquired infections could be a plus. However, all you have to do is walk your rounds in today's hospitals to see who the patients are, frail elderly people, who are often without family to look after them, so the house call bonanza won't apply to the entire population.
This article was written by Roberta Winter, a healthcare advocate who has published under the trademark, healthpolicymaven since 2007, and may be shared virally. For more straight talk on health care programs and policy you can follow me on twitter at:.https://twitter.com/healthpolicymav
Roberta Winter is the author of: Unraveling U.S. Healthcare-A Personal Guide, which may be found at http://www.amazon.com/Unraveling-U-S-Health-Care-Personal/dp/1442222972
(1) Laura Landro, "How House Calls Cut Medical Costs", Wall Street Journal, September 27, 2015
(2) Innovation Projects, Centers for Medicare and Medicaid, Independence at Home, Year One Results http://innovation.cms.gov/Files/x/iah-yroneresults.pdf
(3) Centers for Medicare and Medicaid, Media Release, June 18, 2015