Looming readmission penalties force hospitals to improve transitions

Tools

With hospitals only weeks away from facing steep Medicare penalties for high readmission rates, they are under the gun to carry out safe transitions for patients.

Oct. 1 is shaping up to be hospitals' version of doomsday, in which organizations performing poorly in heart attack, heart failure and pneumonia readmissions could see cuts from 0.42 percent to 1 percent in revenue, which could run well into the high six or low seven figures a year for single, large facilities, FierceHealthFinance reported. And those penalties will only increase--2 percent in October 2013 and up to 3 percent in October 2014.

The Medicare penalties "have been motivating," Marianne Udow-Phillips, director of the policy institute, the Center for Healthcare Research & Transformation, told the Detroit Free Press. "Nothing focuses physicians and hospital executives more than facing financial penalties."

One way to stem readmissions and improve patient care is through "local solutions" with safe transitions between care settings, The Hospitalist reported. For instance, William C. Cook, chief of hospital medicine at the Ohio Permanente Medical Group in Cleveland, is spearheading a transitions pilot with two local nursing homes under the project, Better Health Greater Cleveland, one of the Robert Wood Johnson Foundation's Aligning Forces for Quality collaborations. Safe transitions entail completing real-time discharge summaries for other providers, Cook said.

In another program called Care Transitions, St. Joseph Health System uses a transition coach, who tracks medication adherence and follow-up care, according to the Detroit Free Press. The Michigan hospital system attributes lower readmissions of senior emergency patients to the coaching program.

Texas Health Resources, which is in the process of implementing software to identify at-risk patients recently discharged, also leverages nurse practitioners to make phone calls and home visits for patients after they leave the hospital, KERA, a North Texas NPR station, reported.

"If [patients] do come to the hospital, how well are elements of care transitioned to where they live and work?" Texas Health Resources clinical leader Mark Lester said. "All of those are new features for hospitals who've always focused on taking care of people in the community when they come to us sick and trying to get them better so they can go out. Now, we're really starting to look at what happens when they go out."

For more information:
- read the Hospitalist brief
- see the Detroit Free Press article
- here's the Milwaukee-Wisconsin Journal Sentinel article

Related Articles:
Conference highlights 7 transitional care interventions
HHS calls for more innovations to follow-up care
Borrow best practices for hospital readmission reduction programs