Hospitals Take Steps To Prevent Readmissions To Reduce Costs

Main Category: Public Health
Article Date: 13 Dec 2007 - 10:00 PDT

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The Wall Street Journal on Wednesday examined how hospitals have begun "taking steps to prevent the most common risk to patients after discharge: landing back in the hospital due to complications that could have been prevented with better follow-up care." According to the Journal, a "revolving door of readmissions is driving up costs for hospitals and causing needless harm to patients, especially elderly people with multiple chronic diseases."

Almost 18% of Medicare beneficiaries who are admitted to a hospital are readmitted within 30 days at a cost of $15 billion, according to the Medicare Payment Advisory Commission. As a result, "readmission rates are coming under increasing scrutiny from regulators, insurers, employers and quality-measurement groups, who are considering methods to tie payment to lower readmissions," the Journal reports.

The Institute for Healthcare Improvement has partnered with several hospitals to reduce readmissions through programs that identify patient risk for readmission, schedule follow-up visits with patients before discharge, send nurses on at-home visits to ensure patient adherence to medication regimens, monitor patients at home, and educate patients and families on adherence to medication and self-care regimens.

Most hospitals currently "don't provide such services" in part because they "aren't paid to coordinate care once a patient leaves," the Journal reports. However, "that may change" as managed care companies and health insurers experiment with programs that cover the cost of coordination of patient care, according to the Journal. Randall Krakauer, medical director at Aetna, said, "We believe this can improve the quality of care for members and more than pay for itself by reducing the costs of care by a larger amount than the cost of the home visits" (Landro, Wall Street Journal, 12/12).

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