Discharges and Readmissions: The Impact of Alternative Payment Models

Presented by Nancy Skinner and Colleen Morley

12-Month Subscription

Unlimited access to:

  • Thousands of CE Courses
  • Patient Education
  • Home Exercise Program
  • And more
Video Runtime: 37 Minutes; Learning Assessment Time: 34 Minutes

The Centers for Medicare & Medicaid Services has indicated that 100% of traditional Medicare reimbursement will be value based by 2025. Healthcare professionals may not possess a clear understanding of value-based reimbursement strategies and the regulations adopted to support those strategies. Any gap in that knowledge and/or execution related to current healthcare reimbursement initiatives may negatively impact the financial viability of an organization and/or compromise the status of that organization within the community of practice.

This course will provide a review of associated quality metrics and the strategies under value-based purchasing introduced by the Centers for Medicare & Medicaid Services. The discussion centers around the various alternative payment models and structures that have been implemented to put the focus on quality of care rather than quantity of services. Obtaining an understanding of these initiatives is important as reimbursement in the form of both incentives and disincentives is associated with both provider and payer accountability for the quality as well as the cost of provided care. This course is applicable to physical therapists, occupational therapists, speech-language pathologists, nurses, social workers, and case managers.

Meet your instructors

Nancy Skinner

Nancy has, for the past 30 years, served as a case manager, director of case management, and international case management educator. In her current role as principal consultant for Riverside HealthCare Consulting, she advances programs that promote excellence in care coordination and other transitional care strategies. She…

Read full bio

Colleen Morley

Dr. Colleen Morley has held positions in acute care as director of case management at several acute care facilities and managed care entities in Illinois, overseeing utilization review, case management, and social services for more than 12 years and piloting quality improvement initiatives focused on readmission reduction,…

Read full bio

Chapters & learning objectives

The Transitional Care Team

1. The Transitional Care Team

In this chapter, we explore the evolving role of the transitional team as the patient moves through the care continuum. We discuss the fundamental shifts from length of stay to effectiveness of the plan, from provision of discharge instructions to advancing an understanding and engagement in the information for patient self-management, and the balancing act of financial stewardship and patient advocacy.

Value-Based Payment Models

2. Value-Based Payment Models

We continue with a review of the shifting focus of healthcare from volume to value through a discussion of current alternative payment models and healthcare delivery systems. Concepts including value-based purchasing, bundled payment models, patient-centered medical homes, accountable care organizations, and transitional care management are examined.

The Impact of Transitional Care Management

3. The Impact of Transitional Care Management

Join us for a discussion between the instructors on key transitional care management topics reviewed in this series. The impact of each element is discussed within this lively Q&A.