Too Many Patients Readmitted Within 30 Days
Under the Trump administration, Medicare penalizes Lompoc hospital and many other hospitals across the country for having too many Medicare patients returning to the hospital within 30 days. The Lompoc Valley Medical Center hospital reimbursements from Medicare have been reduced as an incentive to lower the rate of readmission. Medicare reduces what it pays the hospital per patient, per each stay.
$41 Billion Dollar Problem
High rates of readmission to hospitals for Medicare patients have been a national health care concern for years. For the year 2011, these readmissions accounted for annual medical costs estimated at $41 billion by the federal Agency for Healthcare Research and Quality.
Penalty Program Successful
The penalty program for problem hospitals has proved successful as the rate of readmission for Medicare patients dropped from 21.5% in 2015 to 17.8% in 2017. Medicare is cutting these hospitals payments by as much as 3% a year for hospitals that do not meet the required standard.
Some hospitals are creative and give needy patients free medication to increase the rate of recovery. Other hospitals even sent nurses to homes to check patients likely to relapse. Readmissions dropped faster at hospitals being penalized compared to other hospitals, another study found.
$ Penalties Motivate Hospitals To Improve
“The sum of the evidence really suggests that this program is helping people,” said Dr. Susannah Bernheim. Dr. Bernheim is the Director of Quality Measurement at the Yale/Yale-New Haven Hospital Center for Outcomes Research and Evaluation.
Specific Approaches To Lower Readmission Rates
In the Population Health Management eBook, Cheryl Bailey, chief nursing officer and vice president of patient care services at Cullman (Ala.) Regional Medical Center, described the use of a healthcare app.
Nurses at the 145-bed facility record their instructions so patients can listen to the information after they get home. In addition, the app allows patients to access online video and audio clips about their conditions. The app was tested and it reduced 30-day readmissions by 15 percent in six months.
Discovering Causes of Readmission
It’s difficult to keep patients from returning to the hospital if the hospital doesn’t know the reasons why readmission occurred. To determine those reasons, patient input can be particularly valuable. A recent study found that patients with a low degree of knowledge about their own conditions were nearly twice as likely to be readmitted within 30 days. These patients also had a higher risk of ER admission within 30 days of discharge.
Readmissions are often tied to factors outside of hospitals’ control, like income, employment status, etc. If hospitals take the step to make those determinations they can be better prepared to increase the level of education for the patient to prevent readmission.
Phone Contact With Patients After Discharge
One hospital has a nurse discharge advocate follow-up with their patients after discharge. These interventions are an opportunity for patients to tell the advocates how they are doing. For one hospital this approach helped reduce readmissions by 30 percent, according to Christopher Manasseh, M.D., a researcher in an interview with FierceHealthcare for the Population Health Management eBook.
Emphasizing Medication Adherence:
The 87-bed William S. Middleton Memorial Veterans Hospital in Madison, Wis., has a follow-up phone call system that focuses on medication adherence for high-risk elderly patients. It has resulted in 11 percent fewer readmissions and an estimated savings of $1,225 per patient. And follow-up calls to congestive heart failure patients discharged from Charleston (W.V.) Area Medical Center led to 25 percent fewer readmissions among patients who answered the calls. These cases echo similar research showing that at least in the case of heart failure, following up with a familiar physician reduces readmission and mortality rates.
Sometimes effective follow-up requires more than just phone calls. Sacred Heart Hospital, a 250-bed center in Eau Claire, Wis., has both a case management department that makes sure patients are able to care for themselves after discharge and a county transition coordinator who helps patients with problems such as lack of transportation, according to hospital resource director Julia Lyons.
In summary, while Medicare penalizes Lompoc hospital there remain many ways for the hospital to reduce readmission and help improve the quality of the lives of patients.