Guiding a patient through the post-acute care selection process without infringing on patient freedom of choice regulations can be challenging. Many patients don’t understand the importance of high-quality follow-up care and they don’t know what qualities to look for when evaluating a provider. Explaining Medicare quality ratings to patients and caretakers can be time-consuming and it may be tempting to simply tell patients which facility is best for them. However, hospitals are required by law to provide patients with information on all post-acute care providers available to the patients as part of the discharge planning process. Specifically, patient freedom of choice law states:

“The hospital must include in the discharge plan a list of home health care agencies (HHAs) or skilled nursing facilities (SNFs) that are available to the patient, that are participating in the Medicare program, and that serve the geographic area (as defined by the HHA) in which the patient resides, or in the case of a SNF, in the geographic area requested by the patient. HHAs must request to be listed by the hospital as available. This list must only be presented to patients for whom home health care or post-hospital extended care services are indicated and appropriate as determined by the discharge planning evaluation. For patients enrolled in managed care organizations, the hospital must indicate the availability of home health and post hospital extended care services through individuals and entities that have a contract with the managed care organizations. The hospital must document in the patient’s medical record that the list was presented to the patient or to the individual acting on the patient’s behalf. The discharge plan must identify any HHA or SNF to which the patient is referred in which the hospital has a disclosable financial interest.”

In summary, hospitals are compliant with patient choice laws if they:

  • Inform patients they have the freedom to choose
  • Present a neutral list of post-acute care providers to patients with any necessary financial and ownership disclosures
  • Support patients in making their choice without any steering or resistance.
  • Help patients make a choice when the patient (or family/caregiver) cannot choose or seeks input and assistance.

repisodic’s hospital discharge solution empowers case managers and social workers to be reliable sources of unbiased information during discharge planning so you can support and assist patients and their families with their decision without violating patient freedom of choice laws.

Our solution, repisodic Choice, develops a unique list of providers for each patient based on some basic patient information such as location, insurance, and medical condition. Each provider profile has detailed quality metrics, accreditations, and additional information about the facility in an easy-to-understand format so patients and their families feel comfortable making an informed decision about post-hospital care. Our tool helps you show patients how to differentiate between providers while still supporting patient autonomy.

It’s in the best interest of the hospital to optimize their post-acute care management and transitional care services. Providing basic, unbiased information is a simple and legally compliant first step to making the care transition as seamless as possible for the patient. This, in turn, can go a long way in improving patient satisfaction and outcomes. To learn more about repisodic Choice click here.


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