Readmission Reduction: A Must to Stay Afloat

As Medicare puts new reimbursement criteria into effect that are contingent largely on cost reduction, outcomes and quality of care, hospitals and health systems nationwide are focused on readmission reduction to ensure maximum reimbursements.

Why the Eagle Eye on Readmission Rates?

• It’s mandated: In an effort to improve quality of healthcare, the Affordable Care Act created the Hospital Readmissions Reduction Program. This program reduces payments for hospitals with higher than expected readmissions rates within 10 days of discharge.
• Readmissions are expensive: Preventable readmissions are an unnecessary expense, accounting for more than $17 billion in Medicare expenditures every year.

Do the Math

Is the focus on readmission reduction paying off for hospitals? Continue reading for highlights from the data that has been released this year showing that we’re headed in the right direction:

• Between 2010 and 2015, readmission rates fell nationwide by 8%, and 49 states have seen reduced Medicare 30-day readmission rates.
• In 43 states, these rates fell by over 5%, and in 11 states, (including GoMo Health’s New Jersey home base), readmission rates dropped by an impressive 10% or more.

The table below outlines five states that have realized the greatest percentage change in readmission rates from 2010 to 2015, according to CMS:

How They Are Doing It

Technology innovation and simple process improvements are most commonly effecting readmission reduction. Here are just some of the ways that hospitals have worked to lower readmissions:

• Scheduling a seven-day follow-up: Studies show that patients who connected with their physician within one week post-discharge were less likely to be readmitted to the hospital.
• Targeting patients with low English proficiency: Patients with a limited understanding of English are at a higher risk for readmission, so adding translators and sign language experts to your clinical care team ensures that instructions are properly communicated.
• Patient-centered care: Back to the basics – clear communication with the patient establishes a basis of trust and credibility, and an environment for honest expression of needs and concerns, improving satisfaction and outcomes.
• Improving transitional care: Leveraging remote care-management resources, like GoMo Health’s Concierge Care solutions, keeps patients engaged and supported post-discharge so that healthcare providers can ensure proper care continues even after patients leave the facility.