Hospitals Reducing Readmissions Because It’s the Right Thing to Do

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HRE-thumb2It doesn’t take a healthcare expert to deduce that reducing patient readmissions can harm a hospital’s patient volumes. With most of the healthcare industry still operating under a fee-for-service model, this can take a serious chunk out of an organization’s revenue stream.

Down the road, when fee-for-service is ancient history and value-based care is the ruling healthcare model, reducing readmissions will be its own reward, but for now, hospital leaders must decide if it’s worth the financial risk.

According to Rene Letourneau at HealthLeaders Media, many healthcare executives are eschewing the financial side of the coin and focusing on the ultimate reason for reducing readmissions: it’s the right thing to do for the patient.

Recently, the Minnesota Hospital Association’s RARE (Reducing Avoidable Readmissions Effectively) Campaign released a statement, Letourneau reports, that revealed 4,750 readmissions were prevented by its participating hospitals between Jan. 1, 2011, and Dec. 31, 2012.

According to Mark Sonneborn, vice president of information services at the Minnesota Hospital Association, quality of care is motivating these hospitals. “Even with Medicare penalties, a CFO could do the calculations and find it is still worth it to have the readmission despite the penalty… There is still some wariness that we are not there yet, and haven’t really shifted from a fee-for-service to a value-based payment structure. There is a worry about shifting too soon in terms of the bottom line, but everyone agrees this is the right thing to do.”

Barbara Possin, vice president of strategy and quality at one of RARE’s participating hospitals, Essentia Health, expanded on this idea when she said, “I think everyone in healthcare knows that preventing avoidable readmissions is something we need to improve upon because for the patient, any time you have to be rehospitalized, it’s a negative… To say it impacts our bottom line today isn’t going to help us in the future. ”

Essentia has reduced readmissions by 22 percent based on the 2009 baseline. Letourneau writes that the hospital has accomplished this by taking steps “to provide better care transition at the time of hospital discharge, improve medication reconciliation, and conduct follow-up calls with patients to ensure they understand their care instructions and have an appointment with a primary-care doctor within five days of discharge.”

St. Paul’s Regions Hospital, another RARE hospital, managed to reduce its readmission rate by 15 percent in 2012 or 378 readmissions, Josh Brewster, director, care management, said. The hospital has done this by “focusing on efforts such as interventions targeting micro-populations of high-risk patients, improved collaboration and coordination among all care settings, building a culture focused on readmission risks, and closely monitoring non-elective readmission rates across all patient populations and CMS target populations.”

Brewster explained, “Although one of our measures of success was to minimize the Medicare penalties, we see this work as being about excellent patient care and ensuring patients’ care is coordinated. The overall cost of care for the larger health system and improving patient care are more important to us than any impact fewer admissions may have to our bottom line.”

Reducing readmissions because it’s the right thing to do… Who says the future of American healthcare is bleak? It may be difficult, it may be demanding, but with this kind of attitude guiding healthcare executives into the future, it certainly isn’t dark.

-by Pete Fernbaugh

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