Over the past year, generating positive patient and facility outcomes within a rehabilitation unit was a testament to an efficient program with a solid foundation of leadership, staffing and certification. As health systems continue to make the necessary adjustments to better serve the growing medically complex patient population spurred by COVID-19, it is crucial to understand the attributes that contribute to positive outcomes.
Below are two detailed steps and considerations a hospital can take to help ensure facility outcomes are met.
- Measure and track outcomes.
The ability to track and report outcomes is critical for quality improvement and positioning for reform initiatives. Do you capture and track clinical quality metrics? Are you able to compare outcomes to peer facilities? Do you measure hospital readmission rates? Can you demonstrate superior outcomes?
When outcomes are measured and reported, it fosters improvement and adoption of best practices, thus cultivating positive patient experiences and outcomes, and reducing care costs. Further, understanding outcomes is central in providing value to referring providers and payers, and represents an opportunity for enhanced patient care.1
- Know the regulations and comply.
Federal and state regulations -- including adherence to the 60% rule and the requirement that patients receive at least three hours of therapy per day, five days per week -- call for constant attention and oversight, especially following the increased scrutiny and high denial rates many facilities face.
Equally important is documentation competency to ensure accuracy and to reduce denial risk. Do you have a comprehensive pre- and post-admission process to comply with regulations? Are you equipped with a dedicated appeals and denials team to efficiently and successfully navigate the ever-changing denials landscape? Having experts in this field is essential, as the regulatory environment is ever-changing and often difficult to navigate.
When a facility is able to properly measure and track outcomes as well as have a thorough understanding of the latest regulatory changes, they are positioned to achieve long-term patient and facility outcomes.
- Pantaleon, L. (2019, February). Why measuring outcomes is important in health care. Retrieved March 12, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430924/#:~:text=When%