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How to Run a Successful Acute Rehab Program

Improving Outcomes by Overcoming Patient Access and Reimbursement Challenges

In today’s rapidly evolving healthcare environment, providers are faced with more challenges than ever when running acute rehabilitation programs. From treating the right patient at the right time to costly reimbursement battles, there is no shortage of issues that can interfere with delivering the best level of care.

Addressing these problems is especially urgent when it comes to treating highly acute patients. To succeed, providers must learn strategies for overcoming the two most daunting obstacles: patient access and reimbursement.

This guide examines the best practices for meeting these challenges. Serving as a case study is a partnership between Kindred Hospital Rehabilitation Services (KHRS) and University Hospitals (UH). The two entities worked together to implement these solutions successfully.


Challenge Icon of figure jumping hurdleCHALLENGE | Patient Access

Establishing a consistent flow of incoming patients who qualify for acute care is vital for a rehabilitation program’s success, and is difficult to accomplish without a specialized partner.

Many factors come into play when determining if a patient meets the stringent criteria required for rehab care.Unfortunately, because rehabilitation is so complex, many providers and payers don’t always know when it is the best solution. This uncertainty can result in costly disputes with payers.

Additionally, for rehab to be most effective, patients need extensive education before admittance. Unlike other forms of care, rehab requires patients to be actively involved in their treatment. Clinical liaisons therefore play a critical role inappropriately educating patients and their families on what rehabilitation entails.

Solutions Icon of arrow hitting bullseye targetSOLUTIONS | View Patient Access Solutions


Challenge Icon of figure jumping hurdleCHALLENGE | Reimbursement

Reimbursement rejections are a common obstacle due to strict standards surrounding patient qualification for acute care programs. These rejections require providers to redirect hours and other valuable resources toward the appeals process rather than concentrating on optimal patient care.

Many providers are reporting denial rates as high as 80-100%,which can translate into losses of hundreds of thousands of dollars.3 Following best practices for reimbursement ensures that providers minimize rejection-related losses.

Solutions Icon of arrow hitting bullseye targetSOLUTIONS | View Reimbursement Solutions


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CASE STUDY: Better Outcomes for Providers and Patients Alike

In order to maximize patient care and gain greater rehab focused expertise, University Hospitals (UH) partnered with Kindred Rehabilitation Services (KHRS). UH selected KHRS for the partnership because of its successful track record and extensive experience addressing key concerns including patient access and regulations. For instance, KHRS relieved the burden of managing the appeal process by deploying their specialized Appeal and Denial Management Team, which has a success rate of 90%. Read More

 


How KHRS Can Help

Kindred Hospital Rehabilitation Services’ clinical expertise, technology and patient engagement tools help over 150 hospital-based programs achieve operational success and the best possible patient outcomes.

Contact us today to learn more about why KHRS is the partner of choice for hospital systems across the country.

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References
  1. Alkhenizan A, Shaw C. Impact of Accreditation on the Quality of Healthcare Services: a Systematic Review of the Literature. Annals of Saudi Medicine. 2011;31(4):407-416. doi:10.4103/0256-4947.83204.
  2. CARF International. Accreditation Benefits. http://www.carf.org/Accreditation/ValueOfAccreditation/Benefits/.
  3. Youngstrom N, B Anholzer. IRF Claim Denials Are Mounting; Auditors Use Coverage Guidelines, Eye Physician Notes. Report on Medicare Compliance. 2017 Sept;26:1-3. https://www.hcca-info.org/Portals/0/PDFs/Resources/Rpt_Medicare/2017/rmc092517.pdf?ver=2017-09-22-104822-433.

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