Hospitals Face Billions of Dollars in Losses Due to ACA Readmissions Rules


Plantation, FL, Aug. 1, 2013 (GLOBE NEWSWIRE) -- To help hospitals address the Hospital Readmission Reduction Program (HRRP) provision of the Affordable Healthcare Act, Health Revenue Assurance Holdings, Inc. (OTCBB: HRAA) has developed ReadmissionsVisualizerTM to improve and protect revenue by predicting which patients are at high risk for readmissions.

ReadmissionsVisualizerTM, currently being beta tested by multiple hospital systems, is a predictive modeling analytics solution. The product focuses on readmission improvement metrics on high risk patients so hospitals can improve their readmissions profile. Hospital employees ranging from senior level administrators to care managers can utilize ReadmissionsVisualizerTM to identify trends in readmissions, flag patients that are at risk of being readmitted and prioritize action-oriented plans to reduce their likelihood of returning.

Under HHRP the Centers of Medicare and Medicaid (CMS) will fine hospitals for high rates of Medicaid patients -- treated for conditions that include heart failure and pneumonia -- who are readmitted within 30 days of being discharged. The program is expected to save CMS billions of dollars over the next seven years and put thousands of hospitals at financial risk if they do not curb rates.

"A typical hospital with 350 beds will lose between $2.5 and $3 million over three years if they have a poor readmissions rate. We know, from years of working with more than 900 hospitals, which key indicators improve predictions that a patient is at high risk of readmission. These risk factors include poor support systems in the home, prescription medication payment concerns, accessibility of health services and other social and economic data," said Michael Gallagher, MD, chief medical officer of HRAA.

ReadmissionsVisualizerTM provides hospitals with the ability to view current inpatient and historical readmission information through an intuitive Web interface. Key features include:

  • Readmission Dashboard - View of monthly Readmission Results for HF, AMI, Pneumonia, and COPD with patient detail by Practice or Provider.
  • Near-Miss Analysis- View of Emergency Room, Urgent Care and Observation Status to reveal gaps and indicate processes that can be improved.
  • Current Risk - View of current census including Read for Admission, History of CHF/AMI/PN, Readmission Risk Score, Emergency Room History, and Follow-Up Appointments.

"In order to impact readmissions of Medicare patients, hospitals need a way to monitor their performance," continued Dr. Gallagher. "CMS penalties will hurt, and every dollar a hospital loses threatens their ability to provide quality healthcare services to patients."

Andrea Clark, chief executive officer of HRAA reported, "One current customer using the ReadmissionsVisualizerTM was able to put in place a plan that included personal contact through follow-up calls to at-risk patients which reduced their readmission rates. We are confident that other clients will see similar results in the near future."

According to the Centers for Medicare and Medicaid Services (CMS) a total of 2,217 hospitals are expected to be penalized in the first year of the program. Of those 2,217 hospitals, 307 will pay the maximum, one percent penalty of their regular Medicare reimbursements. The penalty cap will increase to two percent in 2014 and three percent in 2015.


HRAA (OTCBB: HRAA) interprets data to ensure that healthcare is efficient and effective for everyone by pulling medical data together to create a predictive window to understand cost and revenues looking back and going forward. Founded in 2001 and based out of Plantation, FL, HRAA combines years of industry expertise with best-in-breed technology to create market leading business intelligence products and consulting services to ensure hospitals are reimbursed for every pill they prescribe, every procedure they perform and every test they administer. HRAA both trains and supplies the high tech workforce to hospitals to generate the predictive data used by the whole healthcare system and offers a full suite of solutions needed to keep up with the ever-changing healthcare industry including data analytics software, business intelligence technology, medical coding, auditing, education, revenue cycle consulting, and ICD-10 transition solutions. For more information please visit:

Caution Regarding Forward Looking Statements

Certain statements in this news release and such conference call are forward-looking, including (without limitation) expectations or guidance respecting customer contract expansion, growing revenues and profits through organic growth and acquisitions, attracting new business that will increase HRAA's revenues, continuing to maintain costs and consummating any transactions. Undue reliance should not be placed on such forward-looking statements because the matters they describe are subject to known and unknown risks, uncertainties and other unpredictable factors, many of which are beyond the Company's control. The Company's actual results, performance and trends could differ materially from those indicated or implied by such statements as a result of various factors, including (without limitation) the continued strengthening of HRAA's selling and marketing functions, continued customer satisfaction and contract renewal, new product development, continued availability of capable dedicated personnel, continued cost management, the success and availability of acquisitions, availability of financing and other factors, as well as by factors applicable to most companies such as general economic, competitive and other business and civil conditions. Information regarding certain of those and other risk factors and cautionary statements that could affect future results, performance or trends are discussed in HRAA's most recent annual report on Form 10-K, quarterly reports on Form 10-Q, and other filings made with the Securities and Exchange Commission from time to time. All of the Company's forward-looking statements are expressly qualified by all such risk factors and other cautionary statements.

# # #

CONTACT: Media Contacts: Danielle DeVoren / Renatta Siewert KCSA Strategic Communications 212-896-1272 / 212-896-1251 / Investor Contacts: KCSA Strategic Communications Philip Carlson / Alex Woodbury 212.896.1233 / 212.896.1267 /

Source:Health Revenue Assurance Associates, Inc.