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Inpatient Hospital Transitions (IHT) 

Background       

  • Health First Colorado is required by statute to have an inpatient hospital review program (Colorado Revised Statutes, 25.5-4-402.  Providers - hospital reimbursement - hospital review program- rules.) 
  • RAEs and hospitals provided input prior to implementation of IHRP 2.0 to tailor a program to create value.
  • IHRP 2.0 duplicated other HCPF programs designed to help with hard-to-place, high need patients, and effective transitions of care.
  • While we cannot abandon an inpatient hospital review program, we can tailor and enhance it to be of the most use to hospitals and RAEs.  
  • If you would like more detailed information about IHT, please review the Inpatient Hospital Transitions presentation.

Timeline

  • July 11, 2024 – IHT announced to Joint Operating Committee with follow up communication on webpage and via email
  • September 9, 2024 – IHT go-live 

Inpatient Hospital Transitions (IHT)  

Inpatient Hospital Transitions are:  

  • Not associated with authorization for inpatient stay or provider reimbursement.  
  • A mechanism for hospitals to share focused member-specific information with the RAEs to ensure successful discharge planning.  
  • The first step in the official communication from hospitals to the RAEs when the hospitals need assistance for a member discharge or transition.  
  • Focused on complex inpatient hospital transitions from one level of care to another.  

Inpatient Hospital Transitions components:  

  • Hospitals will follow the current process of submitting the request for RAE assistance as part of the newly designed “IHT Questionnaire” housed in Acentra’s PAR Platform (Atrezzo).  
  •  Includes all hospitalized non- Neonatal Intensive Care Unit (NICU) patients, in which the hospital determines to have a complex discharge plan, rather than a subset of select diagnosis.  
  • All inpatients (non-NICU) at hospital day 30 and every 30 days thereafter.  
  • NICU members only:    
    • Hospitals need only submit one time on every NICU admission
    • NICU Level I: Well Newborn Nursery and NICU Level II: Special Care Nursery are exempt.  

Training

IHT Training - please register prior to training

Additional Training

IHT Joint Operating Committee (JOC) 

The IHT Joint Operating Committee (JOC) will continue to meet monthly to discuss questions, issues, results and best practices. Upcoming meetings include:

  • July 11, 2024 from 1:00-2:00 p.m.
  • August 15 and 29, 2024 from 1:00-2:00 p.m
  • September 5 and the first Thursday of the month for the remainder of 2024 from 1:00-2:00 p.m. 

To be added to the JOC Meeting calendar invite, please send your name, facility name and your email address to hcpf_um@state.co.us.

Contact either the ColoradoPAR Program Utilization Management (UM) Team at hcpf_um@state.co.us or Acentra® (formerly Kepro) Provider Relations at COproviderissue@acentra.com with questions or for additional assistance.

Contact Information

Colorado PAR Program UM Team: hcpf_um@state.co.us

Acentra Provider Relations: coproviderissue@acetra.com 

Additional Contact Information

IHT RAE Contacts