Hospitals and Outpatient Providers Transforming Care Management Systems to Exceed New Requirements

Our aim is to transform systems of care by helping hospitals and community care organizations expand upon existing partnerships to form and strengthen patient-centered care networks.  Utilizing proven quality methods of collaboration, idealized design and testing, IBHI can aid newly formed or existing networks to dramatically improve care and meet the higher performance requirements of the Affordable Care Act (ACA).

Proposed CMS standards place a priority on reducing preventable readmission rates. Beginning in 2013 hospitals will lose Medicare reimbursement when readmissions within 30 days are higher than federally established limits.  Potential Medicare reimbursement losses can be millions of dollars.  To avoid these penalties, and the accompanying poor community and provider relations issues, consider joining IBHI’s planned learning Collaborative.

IBHI plans to launch a collaborative effort August 15th for hospitals and partnered community-based providers to design systems of care specifically targeted to the population with both behavioral health care and other co-morbidities. Through a proven approach, the Transforming Care Methodology for Behavioral Health (TCMBH), hospitals and other providers are organized into systems of care which will:

  • Reduce hospital readmissions and ED utilization within 30 days of discharge for consumers with behavioral health and other co-morbidities by 5% in the first six months and 20% by 2014,
  • Improve consumers experience with care,
  • Integrate the systems redesign methods (TCMBH) for improving care in participating organizations,
  • Reduce adverse effects and costs of  polypharmacy and inter-drug adverse reactions
  • Train organizations in the appropriate use of Peer Counselors, and
  • Demonstrate other new roles in care coordination within re-designed systems.

Click here for the complete paper on this initiative.

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