Internal Policies

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.

Professional Skills: Written Communication, Technology, and Critical Thinking and Problem Solving are assessed in this Competency.

Your response to this Assessment should:

• Download the Academic Writing Expectations Checklist to use as a guide when completing your Assessment. Responses that do not meet the expectations of scholarly writing will be returned without scoring. Properly formatted APA citations and references must be provided, where appropriate.
• Be sure to use scholarly academic resources as specified in the rubric. This means using Walden Library databases to obtain peer reviewed articles. Additionally, .gov (government expert sources) are a quality resource option. Note: Internet and .com sources do not meet this requirement. Contact your coach or SME for guidance on using Library Databases.
• Carefully review the rubric for the Assessment as part of your preparation to complete your Assessment work.

Assessment requires submission of one (1) document (Part I) and one (1) PowerPoint presentation (Part II). Save the Word document as LE003_PartI_firstinitial_lastname (for example, LE003_PartI_J_Smith). Save the PowerPoint Presentation as LE003_PartII_firstinitial_lastname. When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.

Instructions

Before submitting your Assessment, carefully review the rubric. This is the same rubric the assessor will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.

Rubric

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.

Access the following to complete this Assessment:

• Brooklyn Presbyterian Hospital Acute Inpatient Hospital Admissions Payment Policy
• Brooklyn Presbyterian Hospital—Unplanned Readmission Rates (from Medicare Hospital Compare)
• James, J. (2013). Medicare Hospital Readmissions Reduction Program. Retrieved from http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=102

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 current, “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).
• Identify two factors at Brooklyn Presbyterian Hospital based on the current policy that contribute to the risk of failing to meet HRRP criteria.
• Explain how current internal practices and the changes in policy might positively impact alignment to current and future healthcare laws.
• Suggest one revision to the current policy to help Brooklyn Presbyterian Hospital meet HRRP criteria.
• Suggest one change in current practice across the hospital’s organization in order to help Brooklyn Presbyterian Hospital meet changes in Medicare reimbursement. Include 2–3 sentences explaining the importance of adapting internal policies and practices to align with changes in healthcare laws and regulations.
• Describe at least three key elements needed in a new program to earn the maximum reimbursement under HRRP by reducing readmission rates.
• Create five goals for Brooklyn Presbyterian Hospital for earning the maximum reimbursement by following the HRRP criteria. These goals may focus on processes or outcomes.

Part II: Developing an Action Plan 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.