Bro ref

A readmission can more than double the episode cost.

Chart 6: Cost of 30-day Fixed-length Episode with and without a Readmission, 2007-2009 $32,262 $29,803 $23,527

No Readmission Readmission

$23,034

$23,844

$18,128

$12,301

MS-DRG 247

$19,243

$14,977

MS-DRG 470

MS-DRG 481

$12,075

$5,514

$8,492

MS-DRG 192

MS-DRG 194 MS-DRG 291

247: Percutaneous cardiovescular procedure with drug-eluting stent w/MCC 470: Major joint replacement or reattachment of lower extremity w/o MCC 481: Hip & femur procedures except major joint w/CC 192: Chronic obstructive pulmonary disease w/o CC/MCC 194: Simple pneumonia & pleurisy w/CC 291: Heart failure & shock w/MCC Source: Dobson | DaVanzo (2012). Medicare Payment Bunding: Insight from Claims Data and Policy Implications.

PEAK RESOURCES BUNDLE PAYMENT INITIATIVE 101 Baines Court, Cary, NC 27511 Telephone: (919) 290-2722 Fax: (919) 447-7945

www.peakresourcesinc.com

To reduce the cost of care throughout the post-acute continuum for Medicare and Medicaid beneficiaries.

ON A QUARTERLY BASIS WE CAN ELECT TO ENROLL IN MORE EPISODES AS DEEMED NECESSARY

highest rate of Episodes readmission

ACUTE MYOCARDIAL INFARCTION

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

CONGESTIVE HEART FAILURE

Who We Are HOW ARE WE GOING TO ACCOMPLISH? 1. Most significant area of opportunity is to reduce the number of hospital readmissions. Not only within the first 30 days but throughout the entire 90 day episode

HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT

SIMPLE PNEUMONIA AND RESPIRATORY INFECTIONS

a. Early intervention of Home Health b. Medipak@Home where we provide 30 days of medications upon discharge. c. Advanced Directives discussed upon admission d. Disease specific care paths e. Use of INTERACT root cause analysis for all unplanned hospital discharges f. Use of INTERACT stop and watch too! g. Setting up primary care physician visits prior to discharge

2. Collaboration is necessary with Medical Directors, Home Health, Primary Hospitals and Primary Care physicians.

4. Care Transition Navigator will be in place to monitor bundled payment beneficiaries as well as internal and external process improvement efforts.

3. Identify changes needed in our internal processes to improve the transition of care

5. Developing Gain-Sharing protocol to incentivize each party throughout the continuum of care.

April 1, 2015 Awardee Facilities Peak Resources Charlotte Peak Resources Cherryville Peak Resources Gastonia Peak Resources Treyburn

July 1, 2015 Awardee Facilities Peak Resources Alamance Peak Resources Pinelake Peak Resources Shelby