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.

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.

This Assessment requires submission of one (1) document (Part I) and one (1) Slide presentation (Part II).

• Save the Word document as LE003_PartI_firstinitial_lastname (for example, LE003_PartI_J_Smith).
• Save the slide presentation as LE003_PartII_firstinitial_lastname (for example, LE003_PartII_J_Smith).

When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.

Instructions

Imagine you are an administrator at Brooklyn Presbyterian Hospital in Brooklyn. One day you arrive at work to find an urgent memo from your CEO: Medicare has released its data on unplanned 30-day hospital readmission rates, and your hospital is being penalized at the maximum rate for having an exceptionally high rate of unplanned 30-day readmissions. Alarmed by these statistics, your CEO gives you a special project, outlined in Part I and Part II below.

Rubric

This assessment has two-parts. Click each of the items below to complete this assessment.

Part I: 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 “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).
  • Explain whether you think HRRP has a positive or negative impact on Brooklyn Presbyterian Hospital’s delivery of care and explain the rationale for your opinion.
  • Identify two factors at Brooklyn Presbyterian Hospital based on the statistical report of Brooklyn Presbyterian Hospital’s unplanned readmission rates that contribute to the risk of failing to meet HRRP criteria. Use additional ideas related to HRRP policies.
  • Create five SMART goals for Brooklyn Presbyterian Hospital for earning the maximum reimbursement by following the HRRP criteria. These goals may focus on processes or outcomes.
  • Describe at least three programs or activities based on the SMART goals you created that would help the hospital increase reimbursement under HRRP by reducing readmission rates.

Part II: Developing an Action Plan in a slide presentation 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.