HealthcareDIVE looks at how Maryland has been helping its rural hospitals weather reimbursement challenges through implementing implementing an alternative approach to managing rising hospital costs: the total patient revenue (TPR) program.
TPR, created by the Maryland Health Services Cost Review Commission (HSCRC), gives “hospitals a financial incentive to change the way they manage their resources, with the ultimate goal of slowing down cost increases while preserving the quality of care. Maryland already regulates charges in all the state’s acute care hospitals, but TPR takes it a step farther.’’
The news service says that HSCRC “examines a hospital’s patient mix and services and sets the amount of revenue that a hospital will get each year from the patients in its service area. At the beginning of each year, the hospital knows what its total revenue that year will be. The amount of revenue may be adjusted annually to take into consideration changes in the community, changes in service levels or shifting of services to other settings.’’
“Hospitals are encouraged to focus on improving care and managing health at the community level. They are financially motivated to control lengths of stay, reduce unnecessary testing, prevent inappropriate admissions, and generally operate in a more efficient manner. They are also incentivized to reduce readmissions, a strong motivator for careful patient education and post-discharge follow-up.’’
“TPR has been introduced slowly and only to sole community provider hospitals and hospitals in areas of the state that do not have ‘densely overlapping’ service areas – rural hospitals, essentially.’’
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