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Leveraging Integrated Hospital Care to Revenue Cycle Management. Pharmacist enabled chronic care cycle management. Foreword. Care cycle management of patients in the Meridian system require more integrated foundation and experience in order to increase total reimbursement mix.

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leveraging integrated hospital care to revenue cycle management

Leveraging Integrated Hospital Care to Revenue Cycle Management

Pharmacist enabled chronic care cycle management

foreword
Foreword
  • Care cycle management of patients in the Meridian system require more integrated foundation and experience in order to increase total reimbursement mix.
  • Forward looking innovation coupled with risk minimization can drive cultural change and increase adoption speed towards market changes.
  • Drawing value and delivering accountable management techniques will decreasoeperationalfriction to improves outcomes, reduces waste and increase efficiency.
objectives
Objectives
  • Finalize current pilot initiative to expand, grow and leverage pharmacy operations to optimize HCAHPs scores.
  • Explore, pilot and demonstrate capabilities of pharmacist interventions at inpatient and outpatient setting aligned to hospital revenue goals of HCAHPs, Readmissions, Costs and Revenue generation.
  • Evaluate, initiate, develop and prepare processes for outpatient pharmacy program management including medication reconciliation and adherence, HCAHPs pull through, Annual Wellness Exam enrollment and Transition of Care Management initiation.
overview
Overview
  • Cost Savings and Revenue Generation Options
    • All Unit HCAHPs Program
    • Transition of Care Management (TCM)
    • Medication Adherence (iMPAK Health Customer Validation)
    • Medication Reconciliation Process Change
  • Inpatient Program Expansion
    • Program Overview
    • Timeline
    • Implementation Keys
    • Process
slide5
Strategic Hospital and Corporate ValueService additions and program management leads to growth in operating margins
slide6
Strategic Value & Importance Weight of value predominantly relies on timing, location, benefit upside and immediacy of margin improvement

Medication Reconciliation Process Change

HCAHPs Program Roll Out

iMPAK Health

ED Pharmacist

HCAHPs Program

Low

High

Current Level Of Strategic Value & Importance

Medication Adherence Pilot and Validation

Outpatient

Pharmacy

TCM Program

Transition of Care Management Service Role & Billing

Annual Wellness Exam/CLIA Waived Exams

slide7

Program Roll Out Overview 5 Key Programs lead incremental improvements in operating margins and efficiency aligned to outcomes, talent management and patient journey improvement

slide8

1. HCAHPs Nursing Unit Program Overview10 week comprehensive program enables nursing to own patient experience with ‘as needed’ interventions

slide9

2. Transition of Care Program Overview CMS (CPT) Billing codes of transition of care management can be explored for enhanced discharging and profitability

slide10

3. Med. Adherence Program Pilot Overview10 Week Program focuses on medication adherence and follow up validates iMPAK Health product acquisition value

slide11

4. Med. Reconciliation Program OverviewProgram shifts work burden to pharmacy owned med rec upon admission and oversight of stay and discharge med rec

slide12

5. Outpatient Pharmacy OptimizationRiverview Outpatient Pharmacy preparation and diligence are key to maximizing future hospital revenue and value

program timelines
Program Timelines

1

1

1

2

2

2

3

3

3

Q1

4

4

March

April

May

June

J - S

1

2

3

4

Program Development

(HCP Partnership)

Exploration & Discussion

Training

Initiate

Med Adherence (iMPAK Health) Program

Medication Reconciliation

Discussion

TCM Program

HCAHPs Program

iPad Program Pilot

Report 2

Report 1

Execute

Report 2

Accountability

Report 1

Monitoring

Pilot Enrolment

Monitoring Ends

Role fulfilment

Employment

Assess

KPI Assessment

Product Assessment

Program Begin

implementation process strategy
Implementation Process & Strategy
  • As ACO models continually shift against CMS changes for reimbursement, it has become more clear a team-based care approach would improve outcomes and reimbursement.
  • Key Execution Points
  • Individual practitioners require more conscious use of talent including knowledge of skill set building and enhancements.
  • ‘Group think’ surrounding feedback transparency with accountability reporting towards results will induce sentiment change.
  • Employee sentiments require increased desire to align towards results. (Multifaceted Drivers*)
  • Technology surrounding information and communication can optimize fluidity and continuity of care for patient satisfaction.
  • Partnership with commercial cross functional departments can leverage increased value to hospital stakeholders and carve out Riverview’s niche amongst future competition.

Objectives:

Review future pharmacy outlook and evolution.

Understand potential upside and exploration points to enhance community perception.

Align on program next steps and initiate communication needed.

slide15

Pharmacist Enabled Care Cycle Management

4. CRM Contact *

1. ER Pharmacist

2. Pharmacy Oversight

3. Video: Pharmacist