Aetna, Genesis HealthCare Take Aim at Preventing Hospital Readmissions

-- First national quality program for post-acute care facilities designed to increase and reward improved patient outcomes --

HARTFORD, Conn.--(BUSINESS WIRE)-- Aetna (NYSE: AET) and Genesis HealthCare, a leading provider of post-acute nursing and rehabilitation services, have launched a series of process and care improvements designed to help patients recover more easily and avoid health issues that often send them back to the hospital.

Given the serious health issues faced by recently hospitalized patients who move to post-acute care facilities, some readmissions can’t be avoided. Still, Aetna and Genesis HealthCare believe there is room for improvement and have developed a new quality program. This program is expected to decrease the number of patient readmissions from their facilities by as much as 10 to 20 percent over the next several years. Avoiding these readmissions will prevent almost $2 million in additional medical costs annually.

"Aetna and Genesis HealthCare are like-minded in our commitment to helping people receive high quality care,” says Carl King, head of Aetna National Networks and Contracting Services. “We took an honest look at the challenges patients face during recovery from a major procedure or condition such as hip or knee replacement or congestive heart failure. We have found real ways to improve care so that patients can avoid additional hospital care.”

Patients, of course, will benefit the most from the program when they are able to avoid another hospital stay and recover more quickly. Aetna’s plan sponsor customers will also benefit from the expected reduction in medical costs. Genesis HealthCare is dedicating employee time and resources to this enhanced approach to patient safety and quality care. In return, Genesis HealthCare is eligible for rewards based on achieving targeted measures of improved outcomes.

Small steps make big impact on patient’s health and recovery

Aetna and Genesis HealthCare took a close look at the most common causes of hospital readmission, such as infections. Clinical experts from both organizations worked together to develop a list of relatively simple steps that could be quickly implemented to prevent the causes.

Genesis HealthCare has enhanced their staffing, clinical care procedures and patient support. For example, Aetna’s patients who are referred to Genesis HealthCare’s post-acute care facilities will have primary care services available from Genesis-based doctors or nurse practitioners if needed. Patients do not have to depend on their own primary care providers to stop by, instead the facility providers can deliver or coordinate needed care for complications that often lead to readmissions. Patients also have increased access to rehabilitation services, including in many facilities, specializations in orthopedic, cardiac, pulmonary and transitional care. More frequent therapy has been shown in practice to help speed recovery and speed transition to home, especially for orthopedic and cardiac patients.

The patient’s first few days at home are also critical. To help patients successfully make the transition, Aetna and Genesis HealthCare clinical care teams developed an expanded discharge planning and education program for patients and their families. The new procedures ensure greater coordination and follow up between patients and their doctors. Patients, their families and their doctors have a better understanding of when discharge will occur, what to expect and how to get needed services. The teams ensure treatment plans are being followed and quickly engage the patient for further support.

“Our goal is to recognize and enhance the coordination of care before, during and after a post-acute rehabilitation stay," said Paul Bach, Genesis HealthCare’s Central Area president. “Ensuring each patient has a designated primary care physician and a scheduled follow up appointment before leaving the facility, for example, will result in better long-term outcomes. Steps such as these, however, are often the most difficult for patients to accomplish. With a little help, we are making the transition easier for patients.”

The new quality program procedures were implemented at the majority of the Genesis HealthCare post-acute care facilities this spring.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 36.5 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com.

About Genesis HealthCare

Genesis HealthCare operates more than 200 post-acute care centers and assisted living residences in 13 states. They also supply contract rehabilitation therapy to more than 1,100 healthcare providers in 28 states and the District of Columbia. For more information, information, go to www.genesishcc.com.



CONTACT:

Aetna
Tammy Arnold, 713/721-7891
[email protected]

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