Care Coordination Support & Training (CCM, TCM, etc.) 

Project Description: Care coordination is not a new concept in the healthcare realm, but it has gained renewed attention as systems strive to achieve patient centered care. Valuable care coordination programs such as CCM and TCM have proven to produce measurable outcomes, and many healthcare systems recognize the impact that these simple programs can provide. Despite this knowledge, there is still a noticeable lack of care coordination processes throughout clinics and hospitals nationwide. Led by a Care Coordination/Management Specialist, this program will help those healthcare providers recognize the many care coordination opportunities available to them, and how those processes will help them to address and close patient care gaps while improving positive patient outcomes. The program can assist some facilities in working towards the implementation of a CCM or TCM program that fits the needs of the community they serve. And other facilities that are not yet ready to implement CCM or TCM, the program will help them to identify processes to implement that will address their individualized care coordination need. Participants will be provided with education on care coordination workflows, data and quality improvement impacts, and reimbursement processes and opportunities. At the end of this support and training, facilities will be equipped with the knowledge and the tools to implement a care coordination process to fit the needs of their healthcare facility.

Next Steps:

1.) Complete the READINESS ASSESSMENT: Care Coordination Project – SHIP 2019-20 

2.) Complete call with Lesa Schlatman

Project Resources presented during Iowa Project Innovation Workshop on 9.18.19:

• Innovations in Care Coordination
• Innovations in Care Coordination CMS Report Referenced

Support Courses:

– Care Coordination Considerations for Case Management in the Emergency Room (0.1 CEU)

– Care Coordination Considerations for Identifying Additional Areas of Preventative Medicine (0.1 CEU)

– Care Coordination Considerations for Medication-Related Services (0.1 CEU)

– Care Coordination Considerations for Overutilization of the Emergency Room (0.1 CEU)

– Care Coordination Considerations for Special Patient Populations – coming soon!

– Care Coordination Considerations for Special Patient Populations Project Impact (0.1 CEU)

– Care Coordination Considerations for Telehealth & Telemedicine (0.1 CEU)

Process Improvement Series: Lean Six Sigma Belt  Certification Project

SigmaMed Solutions developed the Process Improvement Training series to provide Iowa hospital improvement teams or leaders with hands-on experience using the vital few tools of Lean Six Sigma. Several pressing issues are selected by the entire group and participants may join the team working on the problem that is most relevant to them. It will be possible for participant team leaders to earn a Green Belt certification and eventually certify as Black Belt Transformation Leaders if desired, and complete 3 more mentored projects with SigmaMed.

Project Status: In Progress

Next Steps:

1.) Complete call with James Martin to choose project and select date for onsite visit

Register here for the Webinar Series

• March 17, 2020 – Individual hospital meetings to discuss progress, lessons learned, and plans moving forward during the 4th Annual Iowa Small Hospital Conference March 18-20, 2020 Marriott West Des Moines 1250 Jordan Creek Parkway West Des Moines, IA 50266 – Cancelled due to Conference conversion to virtual

– Please schedule your session by Friday March 13th by contacting Susannah Cowart at [email protected]

Swing Bed/Skilled Nursing/Post-Acute/PDPM Onsite Consultation 

Swing beds have increasingly been a significant boon to Critical Access Hospital (CAH) and Rural Hospital (PPS) inpatient revenues. While some programs have structured clinical and financial benefits and are looking for ways to increase census, others have been plagued by change in leadership program or limited training resources. The opportunities go beyond the hospital program as rural hospitals with swing beds are creatively and expeditiously helping their communities build a health care continuum, from community coalition leadership to starting aging in place actions.

During this critical juncture in health care issues and opportunities, Kerry Dunning will provide a foundation of training under two key areas:
1. “Build It” – helping hospitals ensure their current swing bed program is compliant, meeting
clinical and billing standards, including the training of staff and providers
2. “They Will Come” – assisting hospitals in setting defined goals to grow their programs,
including census, patient types, and regional influence in growing a coordinated effort in care
for the elderly.
While the underpinning of training will promote compliance – including the changes PDPM will bring to both CAH and PPS swing beds in understanding Medicare intent for skilled nursing – each hospital swing bed program will be given the tools and guidance to structure a plan specific to their current needs while considering the broader impact swing beds and related services will play in the next five years.

Questions? Contact Kerry Dunning at [email protected].

Project Status: Completed

Schedule of Onsite Visits:

Bonus Resources:

• Activity Log for Swing Bed
• Activity Log for Swing Bed (example)
• Admissions Policy (sample)
• CAH Swing Bed Audit Tool
• Regulations and Interpretive Guidelines for Swing Beds in CAHs
• CMS Transfer Discharge Clarification
• Detailed Explanation of Non-coverage
• MDS Resident Assessment
• Notice of Medicare Non-Coverage
• Physician Certification Form 
• Practical Matter Statement
• Practical Matter Statement (example)
• Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNFABN)
• SNF Quality Measures on MDS
• Swing Bed Fact Sheet from CMS

Quality Related Onsite Consultation (MIPS, HCAHPS, ACO, PCMH, ACO, etc.) 

In this project, an onsite visit and assistance will be provided in an area of hospital choosing, including a Quality Department Review, ACO 101 to Success, Survey Readiness, PCMH/Team Based Care, or Population Health.

Each include up to bi-monthly support calls, webinars and resources both before and after on-site visit; final summary will be completed by February with next steps for ongoing sustainment and success in the area of choice.

Project Status: In progress

Project Resources shared during the Project Resources presented during Iowa Project Innovation Workshop on 9.18.19:
Innovations in Quality Improvement

HCAHPS Implementation (Priority for those not currently reporting HCAHPS) 

The purpose of this project is to assist those hospitals currently not participating in HCAHPS, which is a SHIP Grant required pre-requisite.  In addition, other hospitals that would like to focus on HCAHPS improvement are welcome to select this project.

Focus:
-Identify current challenges/barriers to participate in HCAHPS
-Provide overview of current survey vendors/vetting best source
-Identify methods to provide HCAHPS independently vs vendor
-Establish education tools for staff awareness and understanding of patient
experience survey, methodology and identify areas of improvement
-Create reporting mechanism to staff, management, providers and board

End Result: Participating hospitals will have HCAHPS methodology for participation by end of consortium

Project Status: In progress

Next Steps:

1.) Angie Charlet will reach out to schedule with your team.

Chargemaster Evaluation and Training  

A chargemaster evaluation and recommendation report will be provided for each participating hospital. Follow up Training for hospital department managers to assist them in understanding their chargemaster and to give them the tools, education, and resources needed to it so that it remains compliant and up to date. Each training will be a full day and will include a review of each department’s chargemaster and one on one feedback for managers and chargemaster staff.

Next Steps:

1.Complete the project survey

2. Download your chargemaster to an excel format (include Item Number Department, Modifiers, Revenue Code Charge Amount, CPT/HCPCS code, Any explosion code information)
3. Collect any manual charge forms that you use. (ER charges, Infusions, etc.)
4. Email items 3 & 4 to: [email protected]
5. Sandy will perform reviews in the order which they are received, and will contact you to for scheduling of your staff training day.

Project Status: In Progress

Project Resources shared during the Project Resources presented during Iowa Project Innovation Workshop on 9.18.19:

• Innovations in Price Transparency Handout
• Modifiers Handout

Onsite Revenue Cycle Evaluation 

A Revenue Cycle Evaluation and onsite visit with report will be provided for this project. A questionnaire will be completed prior to the visit. The visit will include department visits, claim reviews, and conversations with staff along with ideas for process improvements. The report will include observations made during the visit with recommendations for improvement.

Next Steps:

1. If selected, complete a HomeTown Health Revenue Cycle Questionnaire and return to Sandy Sage.

2. The visit will be scheduled once questionnaires are completed.

Project Resources shared during the Project Resources presented during Iowa Project Innovation Workshop on 9.18.19:

• Innovations in Price Transparency Handout
• Modifiers Handout

Questions? Contact Sandy Sage at [email protected]

Project Status: In Progress

Service Line: Profitability Analysis

The goal of this project is to equip hospital leadership with an enhanced understanding of where the hospital is winning and losing financially on the services that are currently being offered using information contained in the most recently filed Medicare hospital cost report in conjunction with patient level detail information obtained from the hospital’s information system. With this fundamental understanding, the hospital will be able to develop strategies to improve financial performance.

Next Steps:
1. Complete the Data Element Information Request Form via the secure portal with information provided directly to the named project representative. Please provide the requested information as soon as possible, if you haven’t already done so.

Project Resources shared during the Project Resources presented during Iowa Project Innovation Workshop on 9.18.19:

• Innovations in Service Line Profitability

If you have any questions, please e-mail to [email protected].

Project Status: In Progress

Support Courses:

Profitability Considerations for Behavioral Health Services (0.1 CEU)

Profitability Considerations for ER (0.1 CEU)

Profitability Considerations for Pharmacy Services (0.1 CEU)

Profitability Considerations for RHCs (0.1 CEU)

Profitability Considerations for Swing Bed & Post Acute Care (0.1 CEU)

Profitability Considerations for Telehealth Programs (0.1 CEU)

On-Site Physician CDI Training/Consultation 

This one day onsite visit to your hospital provided by Dr. Jim Dunnick, a Cardiologist and Documentation Auditor, will address training needs of your Physician staff for improved, compliant, Clinical Documentation.

Project Status: Completed

Project Resources shared during the Project Resources presented during Iowa Project Innovation Workshop on 9.18.19:

• Innovations in Physician CDI/Documentation

Hospital Purchase of Hardware/Software

If a hospital has already completed ALL investments listed on the SHIP purchasing menu, the hospital may identify an alternative piece of hardware and/or software ONLY IF: a) the purchase will optimally affect the hospital’s transformation into an accountable care organization, increase value-based purchasing objectives and/or aid in the adoption of ICD-10; and b) the hospital receives pre-approval from the state SHIP Coordinator.

Hospitals can select to purchase hardware or software according to the SHIP Grant Menu in various areas including  ICD-10 Coding Software (PB Menu), or various areas under the ACO menu, including pharmacy services, disease registry development/ implementation, application/implementation of telehealth, or community paramedicine hardware/software (up to $3,500).

Project Status: In Progress

Next Steps:

Participants are welcome to register to attend the September 18, 2019 – Live Training in Johnston, Iowa.  Although there will be no dedicated Technology session at the Fall Workshop, there will be some technology and system focused trainings available at the meeting for Excel Tips and Tricks.

1. Review the SHIP Grant Menu for examples of acceptable purchases under SHIP grant categories.  Note that all expenditures must be made between the dates of June 1, 2019 and May 31, 2020. (FY19 Allowable Investments – Word – 5 pages)
2. Submit your expense for approval online: Hardware/Software Pre-Approval Submission.  Note that all expenditures must receive review and approval. Please allow one week for approval once submitted.
3. Once you have received approval, submit proof of your Hardware/Software Expenditure online.   This must be submitted no later than April 15, 2020.
4. Plan to attend the Spring Conference in March, 2020 where we will hold a Technology Innovation Workshop.  Note: offered virtually due to COVID-19.