6 Resolutions for Community Hospitals

Cora Nucci, January 5, 2011

The new year is not yet a week old and already the healthcare industry is bracing for another turbulent year.  Love the PPACA or loathe it, it is a source of anxiety for healthleaders.  Republicans in Congress are already vowing to repeal the legislation and say they will put the matter to a vote before President Obama makes his State of the Union Address. If the law is rolled back, the consequences will be complicated for providers of all sizes.

Another source of uncertainty for healthcare leaders is the roiling business climate that is spawning a high volume of hospital mergers and acquisitions. How does one form a capital plan, conduct fundraising, or implement an EHR system, if a takeover is imminent?

The truth is, uncertainty is a fact of life and the best way to proceed amidst uncertainty is to identify weaknesses, and resolve to do better. Here are six initiatives that community hospitals should undertake this year:

1. Reduce readmissions
In less than two years, hospitals with higher than expected readmission rates will face federal penalties. There are numerous causes of hospital readmissions—from misdiagnosed pneumonias in older patients, to easily avoidable medical errors—but a closer look at the problem reveals some cutting-edge ideas for slashing readmission rates. Don't wait for the threat of federal fines.

2. RAC-proof hospital admissions
Now is the time to make your facility RAC-ready for 2011.  The best approach is to have a strong compliance plan, says HCPro director of Medicare and Compliance, Kimberly Anderwood Hoy, JD, CPC. For example, wrong-setting" denials account for a third of all Recovery Audit Contractor reimbursement refusals, but can be avoided if hospitals work diligently toward the goal of ensuring consistent admission screening among patients.

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