3 Techniques for Hospitals to Reduce Readmission Rates

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Finding methods to lower hospital readmission rates is a common theme  among hospital executives. After all the money Medicare paid in readmissions and could have saved, $15 million according to a 2005 MedPAC study, $12 million of which was estimated could have been avoided, penalties are strict for readmitting certain cases within a given time frame. Innovative hospitals are experimenting with techniques to mitigate this problem, three of which are rehabilitation services, long-term care facilities, and the medical home model.

Expanding rehab services to discharged patients is a great way to cut back on hospital readmissions. Hospitals’ Medicare payments may be reduced by up to 1% beginning in October of 2012, for patients treated for heart failure, heart attack or pneumonia. Texas Health Arlington Memorial Hospital extended its cardiac rehabilitation department for this very reason. By encouraging each other and working together to improve their health, cardiac patients at Texas Health made incredible progress. The Centers for Medicaid and Medicare cover these types of services echoing Neal Gold’s, M.D., and internist and Director at Sg2, thoughts that many more hospitals that adopt cardiac rehab services may improve quality and control costs.

Do you know the second most common way of releasing a discharged patient from an acute care hospital? The answer may be surprising, long-term care facilities. Next to routine discharges to the patient’s home which accounted for 72% of discharges, nursing homes, inpatient rehab and long-term acute care facilities accounted for 13% of discharges according to a 2008 Agency for Healthcare Research and Quality study. Estimated combined Medicare spending for these three facilities amounted to $37.1 billion in 2009 as a 2010 Medicare Payment Advisory Commission indicated in a Hospitals and Health Network Magazine. Knowing the readmission rates from these long-term care facilities a hospital refers its patients to is an important step in avoiding the penalties that could result.

The third technique a health system may consider as a form of lowering readmissions is the much conversed about patient-centered medical home model. A medical home consists of a team of physicians utilizing electronic health records and other health IT to provide improved preventative care and physician patient interaction. A study done by the Group Health Cooperative, compared a sample of 9,200 medical home patients to a control group and the effects were startling.

After one year medical home patient visits to emergency rooms decreased by 29%, the rate of hospitalizations dropped by 11% and the medical home had 6% fewer in-person visits. Due to the medical home model, costs increased $53 per patient for extra staffing and specialty care. However, less emergency department usage equated to savings of $54 per patient. Patients also reported higher ratings of satisfaction of their experience and considerably less hospital staff felt “burned out” compared to the control group. After seeing the results, Group Health incorporated the medical home model in all its medical centers.

For more information on patient satisfaction see my other blog post on 3 Reasons Hospitals Must Focus on Patient Satisfaction. I also enjoy hearing your feedback so don’t hesitate to comment.

 

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