The lack of transitional care programs in Hawaii has left hospitals with a huge financial problem: A backlog of patients ready for discharge but with no place to go.
A new study by the Hawaii Health Information Corp. (HHIC) estimated these "wait-listed" patients cost hospitals nearly $63 million a year.
Moreover, the number of wait-listed patients is on the rise. In 2011, a total of 7,055 patients were wait-listed, up 11 percent from 2006, according to the Hawaii Reporter.
"What we found is that ultimately, hospitals bear the cost of wait-listed patients," Peter Sybinsky, chief executive officer of the HHIC. "Until more funded community-based treatment alternatives are available, the data indicates we will continue to see unnecessary and inefficient use of Hawaii's most expensive healthcare resources."
Two-thirds of the wait-listed patients are enrolled in Medicare, according to the Associated Press. The hospitals forced to keep these patients lost an average of $1,259 per day, and they spent a week on average in the hospital prior to their final discharge.
Community-based care, which focuses on getting patients out of the hospital and into lower-cost transitional settings as quickly as possible, is often a tough sell to hospitals. The Centers for Medicare & Medicaid Services launched the Community-Based Care Transitions Program in 2011 as part of the Affordable Care Act. Although many hospital leaders objected to one of the tenets of participating in the program--financial penalties for patient readmissions--a variety of community groups agreed to provide services.
Although more hospitals signed up with the program recently, in Hawaii, only one agency has agreed to provide transitional services under the CMS program.
Sybinsky told the Associated Press that for-profit hospitals would be less likely to tolerate the losses of keeping wait-listed patients. However, every acute care provider is either a not-for-profit or government-owned.