Implementing Hospital Readmission Reduction Program in Healthcare Organization

Implementing Health Policy in Healthcare Organizations
Student’s Name
Department, University
Course Number: Course Name
Professor
Date
Implementing Health Policy in Healthcare Organizations
Introduction
In the recent past, healthcare organization leaders have increased their efforts towards reducing rehospitalization rates in their facilities. A hospital readmission case happens when patients are readmitted to a healthcare facility within a given period (30 days according to Medicare guidelines) following their initial hospitalization. The Hospital Readmission Reduction Program (HRRP) is a federal policy tailored to reduce readmission rates by preventing unnecessary rehospitalizations. This paper addresses the challenges that hospital leaders encounter as they integrate HRRP into their health care organization’s internal policies, including the solutions to managing these issues.
HRRP Implementation Challenges
Hospital quality and reimbursement levels can be established using rehospitalization rates for acute myocardial infarction (AMI), pneumonia, and heart failure (HF) amongst Medicare beneficiaries. According to Butala et al. (2018), relative performance varies amongst the illnesses named above and for similar conditions amongst distinct payer groups. The readmission indicators within the HRRP are not tailored to establish the totality of a health care organization’s performance, thus creating implementation challenges (Butala et al., 2018). Health care organizations are increasingly complex, with different interprofessional teams, internal processes, and policies governing patient care and anticipated outcomes with each diagnosis (Boccuti & Casillas, 2017). In addition, rehospitalization rates for various conditions traditionally lack practical concordance, thus making it challenging to integrate the policy into internal processes or measure its impact on treatment and care outcomes. For example, rehospitalization rates for specific illnesses deteriorated substantially more than the figures for nonspecific (nontarget) diseases at healthcare organizations under HRRP-based penalties. These facilities specifically emphasized improving readmission indicators for clients admitted for these target illnesses (Desai et al., 2016). The lack of perfect harmony for readmission rates for different diseases is an implementation challenge for HRRP.
Further, only selected illness-specific readmission indicators are incorporated within the HRRP. On the other side, the Centers for Medicare and Medicaid Services inpatient quality reporting plan includes additional readmission indicators within public domains, including the health care organization-wide readmission indicator (Ellison, 2019). This reinforces an inconsistency in what is reported to the general population. The existing publicly declared indicators are not good surrogates for healthcare organizations’ internal quality policies, especially those related to thirty-day readmissions. Nevertheless, the widely reported hospital-wide indicator is tailored just for that. In addition, the healthcare facility excess readmission ratios for the HRRP-defined illnesses, which are increasingly applied to determine penalties and establish hospi...