Case study: Indiana hospital uses case management to avoid rehospitalizations

Recently, as the health reform debate has evolved, policymakers have paid increasingly close attention to 30-day readmission rates for hospitals. Officials say that cutting down on rehospitalizations cost Medicare $17 billion annually, with one in five Medicare patients being rehospitalized within those first few weeks after discharge.

To reduce the rate of readmissions, one Indiana hospital has developed a package of services to help heart attack patients take the appropriate steps to become stable once they're discharged from the hospital. While the approach isn't rocket science, the steps taken by Bloomington Hospital are still more than many hospitals attempt.

For one thing, a case manager calls heart attack patients within 48 hours of discharge to find out if the patient has filled his prescriptions, had trouble taking those meds and made an appointment for a physician follow-up. The hospital also has developed a scholarship program that helps patients to be able to afford further education as to how to avoid future heart attacks.

Then, within a month, a team including physicians, pharmacists, lab specialists and a quality-control team review the case to see if there are lessons to be learned from the current patient's experience.

Perhaps due to taking these steps, Bloomington Hospital has experienced remarkably low readmission rates. Only 11 hospitals in the U.S. have lower readmission rates for heart attack patients than Bloomington, according to an analysis of Medicare data from 2005 to 2008.

To learn more about Bloomington's efforts:
- read this Indiana Star piece

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