Determining whether a patient should be an inpatient or on observation services can be a challenging call. If the wrong decision is made or the right decision isn't properly documented, the claim will likely be denied.
It's a scenario that plays out at hospitals across thecountry each day. A Medicare patient is scheduled for a procedure typically performed on an outpatient basis. But the patient has a number of preexisting health conditions, such as chronic obstructive pulmonary disease or diabetes, which are going to make the surgery and recovery more complicated.
Sometimes the best care a patient can receive in the ED is to not be treated there at all. They can often have treatment needs and do received meds, but that does not necessarily entail an admission.
The Community-Based Care Transitions Program (CCTP), also known as Grant 3026, is mandated by Section 3026 of the Patient Protection andAffordable Care Act and provides funding to test models for improving care transitions for high-risk Medicare beneficiaries.
When evaluating a family's ability, willingness, and availability to provide needed care to patients, discharge planners may become aware of scenarios that are not reasonable or safe for the patient.
Medical City Hospital (MHC) in Dallas asked its core measurement teams for acute myocardial infarction (AMI), pneumonia, and heart failure to develop readmission reduction processes for each condition.
