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The more your hospital does up front to prepare for Medicare's Recovery Audit Contractor (RAC) program, the more money it will save in the long run, experts say.
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During the Recovery Audit Contractor (RAC) demonstration project, the auditors were extremely focused on the level-of-care orders to the point of denying admissions that did not have a clear admission order such as "admit to inpatient."
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Case managers are under pressure to discharge patients as quickly as possible from the acute care hospital, but they may have liability for negligent, premature discharge, according to Elizabeth Hogue, Esq., a Washington-DC based attorney specializing in health care issues.
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Researchers who reviewed thousands of studies have found that enhanced hospital discharge support might prevent or delay hospital readmissions for heart failure and stroke patients.
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When the RN clinical documentation improvement specialists at Central DuPage Hospital set up a networking meeting with their peers from other hospitals in northern Illinois, they never dreamed that their efforts would lead to the formation of a new organization with regular meetings.
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It took Nancy Sikorski, RN, BA, nearly four months of research, telephone calls, and e-mails to bring together some of the RN clinical documentation improvement specialists in northern Illinois for a meeting.
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A new plan for admitting patients from the ED at Johns Hopkins Bayview Medical Center in Baltimore jointly developed by an ED physician and a hospitalist, decreased ED throughput for admitted patients 98 minutes (from 458 minutes to 360 minutes) from the same period a year earlier, despite an 8.8% increase in the ED census.
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Don't get a false sense of security if the Recovery Audit Contractor (RAC) process seems easy at first, warns Brian Flood, CHC, CIG, Esq., advisory managing director for KPMG LLP's health care practice in Austin, TX.
