To try to reduce the number of hospital discharge appeals, Kepro on May 1 added an informal process for patients who are troubled by their discharge planning, according to its website.^[1] The idea is to nip problems in the bud before moving on to a full-fledged appeal.

Kepro is one of two Beneficiary and Family-Centered Care-Quality Improvement Organizations (QIOs) with CMS contracts to decide appeals in real time from patients who disagree with the hospital’s decision to discharge them. There’s no word yet from the other QIO, Livanta, on whether it plans a similar process, although it now has an online appeal option.^[2]

The new Kepro process hopes to address what it said are appeals filed out of concerns with discharge planning rather than the discharge itself—essentially form over substance. “To address this specific issue, Kepro will work with facilities to ensure that Medicare beneficiaries with Traditional Medicare and/or their representatives clearly understand their discharge plans before continuing with the discharge appeal process,” the QIO stated. If that can be accomplished, maybe the patient and hospital can avoid a formal appeal.