Discharges and Readmissions: The Impact of Alternative Payment Models

Course overview

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.