Readmission rates on the higher end
New data from the Dartmouth Atlas Project and the Robert Wood Johnson Foundation show that in 2010, the hospital readmission rate in Fort Collins was 15.4 percent and in Greeley stood at 15.7 percent.
These numbers are on the higher end of the scale, which ranged between 11.4 percent and 18.1 percent nationwide.
Hospital readmissions have always been an issue, but health care reforms allow the federal Centers for Medicare and Medicaid Services to financially penalize hospitals whose Medicare readmission rates are above the national average, which was about 12.4 percent in 2010, according to the Robert Wood Johnson study.
Beginning in October 2014, hospitals with “excessive” readmissions will experience Medicare payment penalties of up to 3 percent.
The Affordable Care Act is going to change how providers are paid, and the legislation emphasizes quality of care over quantity of care, meaning that where providers used to be paid per-visit, now they’ll be paid for outcomes.
According to Healthcare.gov, beginning Jan. 1, 2015, a new provision will also tie physician payments to the quality of care they provide. Physicians will see their payments modified so that those who provide higher value care will receive higher payments than those who provide lower quality care.
This has motivated providers of all types to re-evaluate the way they look at treating patients beyond pure medical care.
This goes for not just Medicare and Medicaid patients; it applies to everyone who receives care. But the readmission of Medicare patients is one of the most pressing issues, as nearly one in five Medicare patients is hospitalized again within a month of going home.
The legislation hasn’t just set up a system to penalize readmissions, though. The Affordable Care Act also includes a $500 million allotment to be distributed to hospitals with high readmission rates to improve transitions for Medicare patients.
Beyond the financial implications, hospitals in Northern Colorado and elsewhere have started taking steps to reduce readmission rates.
Like many other aspects of health care, in its current ever-changing state, hospital systems and independent providers are coming at the readmissions problem from many different angles, including hiring staff dedicated to helping patients move out of the hospital to their homes.
Administrators at the region’s local hospitals, as well as independent practices, say that often patients don’t truly understand what care is required after they undergo a procedure.
At-home difficulties can range from confusion about which prescription to take, to not having a ride back to the hospital or a primary care provider for follow-up checks.
To mitigate this, many local providers have brought on board, in some capacity, a transition person, or even an entire transition team, to make sure that every aspect of a patient’s recovery is being handled.
For some patients, especially the very elderly or disabled, this means extra care in-home, with which most transition teams are able to assist.
It might seem costlier up front to hire more staff to meet this particular patient need, but the alternative is even less attractive, since re-hospitalizations can cost more than $17 billion per year in avoidable Medicare payments nationwide.
One thing that is clear in this situation is that providers will have to reach far beyond their own facilities to keep their patients healthy and keep their costs down. Before, care was about what happened inside the hospital or operating room, but more and more, it’s becoming the provider’s responsibility to keep patients healthy after they walk out of the hospital.
With hospital readmission rates at about 3 percent above the national average, this is a conversation Northern Colorado hospitals are keeping a close ear to.
Molly Armbrister covers health care for the Business Report. She can be reached at 970- 232-3139, at firstname.lastname@example.org or at twitter.com/MArmbristerNCBR.
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