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Reconciling medications for home health care readmissions
November 1, 2018

This article is for home health care providers.

In the patient’s medical record, please document medication reconciliation for readmitted patients after discharge from an inpatient stay. Because medications often change during hospitalization, it’s important to compare the medications you previously listed in the patient’s medical record with the medications they are now taking since being readmitted to your care.

Documentation of reconciliation with a reference to the previous medication list demonstrates that you are helping to support your patients (our members) with transitions in care.

What to include in the medical record

  • A list of current medications
  • Documentation that the medications were reviewed and reconciled

Why is Blue Cross asking you to do this?
Medication reconciliation post-discharge is both a HEDIS®’ measure1 and part of our CMS Star rating. It requires a review of the medication the patient was prescribed at the facility (hospital, rehab, skilled nursing facility) compared to what they were taking before the admission. This review must take place within 30 days of the discharge, and be performed by a physician, pharmacist, or RN.

Thank you for your support
We appreciate your support with this quality initiative. Working together on these initiatives helps our members receive high-quality care. Please refer to the Compliance with Quality Improvement Activities section of your Agreement with us for more information.

Questions?
If you have questions, please contact our HEDIS support team at
1-888-994-3347.

1 HEDIS is a set of standardized performance measures developed by the National Committee for Quality Assurance. Health plans (and providers) report their performance on these measures and review opportunities for improvement, such as improving documentation to support the measure.

 

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