Norwalk, Connecticut - Hospitals with high Medicare patient readmission rates have just under six months to ramp up their reduction efforts and avoid stiffer financial penalties for patient readmissions. To help, Midas+, A Xerox Company, has developed a powerful, almost 100 percent accurate data-driven solution that estimates excessive readmission rates and the associated financial penalties for two fiscal years in the future.
The Midas+ Readmission Penalty Forecaster’s near real-time measurements include patients who are readmitted within 30 days to a different hospital.
“This isn’t a crystal ball, but the Forecaster can help hospitals get a good look at the future, and do it with enough time to make a change if needed,” said Justin Lanning, senior vice president and a managing director of Xerox Healthcare Provider Solutions. “Hospitals are under pressure to help reduce America’s overall healthcare costs. Insights from analytics help hospitals prioritize their admission reduction efforts and drive quality improvement around patient care.”
To make predictions, the Forecaster crunches five years of Medicare data and links it to a patient’s record in the Midas+ analytics and workflow software platform. With machine learning technology, the system delivers up-to-date insights on patient admissions by leveraging real-time data on every aspect of the clinical care cycle from more than 1,900 hospitals. Replicating government risk models, the platform estimates excess readmission ratios with as much as 99 percent accuracy. Midas+ also will provide on-site consultation for hospitals to respond to areas of concern and implement targeted improvement strategies.
The Centers for Medicare & Medicaid Services (CMS) reduces hospital payments for Medicare beneficiaries if it deems rates of unnecessary and unplanned 30-day readmissions excessive. In 2014, hospitals faced $175 million in penalties, but that figure is expected to reach $424 million in 2015 as the maximum penalty recently increased one percent. To avoid penalty, hospitals must prevent excessive readmissions in six clinical areas for Medicare patients discharged from July 2012 through June 2015.
