Beth Israel Deaconess lowers readmissions with post-discharge program

Faced with an above-average readmission rate, Beth Israel Deaconess Medical Center in Boston is reducing readmissions with a post-discharge program focused on elderly patients, according to Kaiser Health News.

Despite its prestigious reputation, Beth Israel Deaconess had one of the highest Medicare readmission rates in the country in 2012, leading to more than $1 million in fines, according to the article. "Patients coming to our hospital, getting what we believed was high-quality care, were coming back at an alarmingly high rate," Julius Yang, M.D., Ph.D., the hospital's head of quality, told KHN.

Although Beth Israel Deaconess provided quality care to patients during their stay, it did not do enough to ensure their health post-discharge, Yang said. "In the hospital we provide a lot of structure, we provide a lot of staff. We provide a lot of expertise to manage every moment of their illness, but as soon as they leave, the complexity of their situation probably explodes."

This led the hospital to create the Post-Acute Care Transitions (PACT) program through a $5 million federal grant. Under the program, nurses and pharmacists monitor Medicare patients at high risk for readmission, getting in touch with the patients, their caregivers and their primary care providers to answer questions about medication or arrange for nurse visits or rehabilitation as needed, according to the article.

Since the program began, Beth Israel Deaconess has reduced readmissions by 25 percent, said Yang, who directs the program, However, now the hospital faces another problem--every empty bed represents lost revenue. "For a patient to come into the hospital, whether it's a readmission or not, we collect revenue and yet we are being penalized for this," he told KHN.

Post-discharge care is a major component of several successful readmission prevention initiatives. For example, the 87-bed William S. Middleton Memorial Veterans Hospital in Madison, Wis., has a medication-specific follow-up call system that has reduced readmissions by 11 percent and saved $1,225 per patient, FierceHealthcare previously reported.

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