Hospitals Devise Strategies to Tackle 30-Day Readmissions (Part 1 of 4)

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RA-thumb1Many healthcare leaders are taking the new requirements and regulations under healthcare reform one step at a time. To embrace the entirety of federal demands is to bog one’s organization down under a load of paperwork and expense that can be difficult for most organizations to absorb.

Cheryl Clark has an interesting article in the May 2013 issue of HealthLeaders magazine about the way in which many hospitals are handling 30-day readmissions. She points out that many executives are well aware that the government is edging ever so gradually “toward enacting reimbursement penalties for all-cause readmissions” and are preparing their organizations to comply, but only one step at a time.

Many are still focused on heart failure or pneumonia or heart-attack readmissions exclusively, “because those readmissions are the only ones for which hospitals suffer a stiff reimbursement penalty,” Clark writes. “While many hospitals intend to target all-cause readmissions eventually, for now, it represents a steep front-end expense their budgets are not yet ready to absorb in a fee-for-service world, especially for readmissions that are not yet at risk for penalties.”

Readmission prevention expert and practicing physician at Newton-Wellesley Hospital in Massachusetts Amy Boutwell, M.D., MPP, has talked with many hospital leaders, including those at a December seminar from 62 New Jersey hospitals. She recalled, “I asked everyone in the group, ‘Is anyone taking this all-cause approach?’ And none of them were. They just don’t have it on their radar. Their ‘first phase’ of efforts is still very much focused just on one disease. Their challenge in 2013 is to move from one disease-focused pilot to a broad portfolio of efforts.”

This is not the exclusive approach of United States hospitals, however. Clark reports that many “are forging ahead on the all-cause front…working on pilots and special programs that are reducing readmissions regardless of diagnosis, first on a unit or floor, and then across their entire hospital or system.”

They are sacrificing the cost of doing this largely “because they recognize federal rules expand by four the number of conditions in the penalty algorithm by Oct. 1, 2014,” adding chronic obstructive pulmonary disease, coronary stent procedures, vascular surgery, and coronary bypass procedures to the list of penalized 30-day readmissions.

How are these hospitals confronting readmissions? We’ll take a closer look at this over the next couple of posts.

In the meantime, what is your organization doing to reduce readmissions? Are you taking an all-cause approach, or are you concentrating on the diseases for which you can be penalized now?

-by Pete Fernbaugh

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