Question: Our hospital is participating in a two county community collaborative in partnership with the local area agency on aging to prevent hospital readmissions. Two hospitals have started a pilot program while the collaborative has written a grant to the Centers for Medicare and Medicaid Services. The community need the collaborative is addressing is improving access to health services and relief of government burden. The collaborative has many community partners.
Can we report as community benefit the time spent by staff in collaboration meetings, steering committee meetings, planning, data collection and reporting, making referrals to Coleman coach, etc.? We are not sure if efforts to prevent hospital readmissions are part of the continuum of care/care coordination and should not be reported as community benefit.
Recommendation: We recommend reporting quality improvement/care coordination efforts when 1) the primary purpose of the activity is to provide community benefit (improved access or community health improvement, and not to the benefit the organization financially), 2) there is an identified community need for the program (need may be demonstrated by involvement/request of government and/or community groups) and 3) at least one of the following apply:
- The persons receiving the services are vulnerable (low income, mentally ill, homeless or in other ways in need of special services)
- The program is part of a community response to an identified community health need, involving one or more community partners
We recommend being cautious in reporting services where there is a return on investment to the organization, such as avoidance of readmission penalties. However, reducing readmissions should not automatically disqualify an activity from being reported because the admission being prevented may be to another hospital and the reduction in costs benefit the overall health care system. Also, as some of these services become standards of care, expected and performed by all organizations, this recommendation will be revised.
If the activity is reported, all costs can be reported including time spent by staff in collaboration meetings, steering committee meetings, planning, data collection and reporting, making referrals to coaches. We recommend reporting under Category A4, Social and Environmental Improvement Activities.