Adapting Internal Policies and Practices

 
Overview
This Performance Task Assessment is based on a case study set in Brooklyn Presbyterian Hospital, in the Park Slope neighborhood of Brooklyn, New York, as the hospital confronts the new quality standards set by the Patient Protection and Affordable Care Act (PPACA) for Medicare patients. To complete this Assessment, read the scenario below, and then complete Parts I and II that follow. You will use information from the scenario, along with the supporting documents, to demonstrate your ability to adapt internal policies and practices to align with changes to healthcare laws and regulations.

Part 1: Analyzing HRRP Policy and Evaluating Hospital Performance

 
Read the Health Affairs Policy Brief on the “Medicare Hospital Readmissions Reduction Program.” Then, analyze the document “Brooklyn Presbyterian Hospital—Unplanned Readmission Rates,” which presents statistics on the unplanned readmission rates at the hospital and how they compare to the national averages. Also, review the current, “Acute Inpatient Hospital Admissions Payment Policy” document.
Use these resources to develop a report (4–5 pages) to the CEO that completes the following:

Describe the key elements of the Medicare Hospital Readmissions Reduction Program (HRRP) established in the Affordable Care Act (ACA).
Identify two factors at Brooklyn Presbyterian Hospital based on the current policy that contribute to the risk of failing to meet HRRP criteria.
Explain how current internal practices and the changes in policy might positively impact alignment to current and future healthcare laws.
Suggest one revision to the current policy to help Brooklyn Presbyterian Hospital meet HRRP criteria.
Suggest one change in current practice across the hospital’s organization in order to help Brooklyn Presbyterian Hospital meet changes in Medicare reimbursement. Include 2–3 sentences explaining the importance of adapting internal policies and practices to align with changes in healthcare laws and regulations.
Describe at least three key elements needed in a new program to earn the maximum reimbursement under HRRP by reducing readmission rates.
Create five goals for Brooklyn Presbyterian Hospital for earning the maximum reimbursement by following the HRRP criteria. These goals may focus on processes or outcomes.

Part 2: Developing an Action Plan to Maximize Reimbursements and Adapt to Change

 Political pressure will result in changes to Centers for Medicare and Medicaid Services (CMS) policy and reimbursements. Develop a 10- to 12-slide presentation, to senior management, proposing strategies for executing a plan for earning maximum reimbursement under HRRP, specifically by changing the behavior of providers and patients. Your goal is to secure resources to put your plan into action. In this presentation, explain your approach, your plan for implementation, at least two ways you will prepare and monitor for change in CMS policy, and your education plan for staff. 

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