ReAdmission Solutions, LLC
ReAdmission Solutions, LLC (RAS) provides care coordination and management services to health plans, hospitals and accountable care organizations to reduce their patients’ avoidable readmissions to hospitals.
As part of the Affordable Care Act, effective October 1, 2012, the Hospital Readmissions Reduction Program penalizes hospitals for failing to reduce readmissions through escalating penalties that decrease all of an organization’s payments for its Medicare cases. Health plans are impacted through the Medicare Star Rating program incentives for the successful reduction of readmissions. Readmissions are triple-rated by the Centers for Medicare and Medicaid Services (CMS).
According to the New England Journal of Medicine, almost 20% of Medicare patients are readmitted to a hospital within one month of discharge. CMS considers this number excessive and believes that readmissions are indicative of poor quality of care. CMS’ goal is to transition to “value- based purchasing”—paying for care based on quality and not quantity.
ReAdmission Solutions (RAS) is the solution for eliminating unnecessary hospital readmissions.
Unlike its competitors, RAS designs and implements robust readmission reduction programs for all cause hospital readmissions including, but not limited to, congestive health failure, chronic obstructive pulmonary disease, and acute myocardial infarction and pneumonia. Offering comprehensive health care management services to health plans and hospitals, RAS provides the complete continuum of care to its clients’ patients from admission into the hospital, in-hospital collaboration, discharge planning and post-acute care through the length of its client engagement.
The RAS methodology for patient care is based on its proprietary analytics. RAS mines data from patients and physicians to produce population-specific probabilistic models and tracks reasons for unplanned admissions. RAS closely and continually monitors its data so that outcomes can be dynamically integrated into on-going program modifications to meet the evolving needs of the patient population.
RAS’s high touch clinical focus begins at admission with its staff embedded at the hospital and/or health plan working side by side with the hospital staff. RAS partners and collaborates with the hospital’s physicians and other health care providers involved with its clients’ patients including, but not limited to, nurses, pharmacists, dieticians, discharge planners, case managers and hospitalists. RAS integrates the whole care team throughout a patient’s hospital stay, monitoring for infection, reconciling medication therapies and interacting with patient and family to prepare for discharge and at-home care through reinforcing health literacy and family support.
Upon discharge RAS schedules post-discharge physician appointments, home care visits and respiratory therapy treatment. RAS also coordinates registered nurses’ and dieticians’ phone calls and accelerates physician engagement, medication fulfillment and home care. RAS’ personalized post-acute care coordination is enhanced with its use of electronic information and telecommunications technologies to support clinical health care, patient education and health administration. RAS’ innovative telemedicine technology includes secure cloud-based electronic health records, pharmacy benefit management, patient telemonitoring and 24/7 telephonic patient engagement.