An interesting opinion piece titled "Report Card on Healthcare Reform" appeared in the Sunday Review of the NY Times in March, written by the Editorial Board. The answer to the title of this post, "Are Avoidable Readmission Improving Already?" may, in fact, be "Yes." There is early evidence of success that is discussed in the NYT article and that I'll share below.
I'll skip the opening political commentary in the piece because, frankly, it's old news. That ship has sailed, both sides of the aisle in Washington agree that it has sailed, and health care providers of all types are already moving on to reform their businesses for this new era of healthcare. The new era is one that is focused on the triple aim, which seeks to
- Improve the patient experience of care (including quality and satisfaction);
- Improve the health of populations; and
- Reduce the per capita cost of health care.
The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. IHI’s imperitive directs that new models be developed to simultaneously pursue the three primary elements listed above, which are commonly referred to as the “Triple Aim.” Read more about the Tiple Aim by visiting the IHI web page or clicking on the IHI image above.
It should be noted that Accountable Care models, Population Health and Care Transition intiatives, Avoidable Readmissions programs, along with many other approaches, all seek to incorporate "best practices" approaches to healthcare with this Triple Aim in mind.
With that in mind, and with the first stage of Readmission penalities enacted in 2012 --already a whopping 1% of TOTAL Medicare reimbursements if a hospital fails to meet new readmissions standards on certain patients--hospitals have are already focusing intensely on mitigating these costly readmissions.
So has there already been improvement? Early data suggests that, yes, just the very existence of the first round of penalties is already improving focus and quality.
"One of the most promising aspects of the health reform act is its focus on improving quality," says the NYT. "The percentage of Medicare patients requiring readmission to the hospital within 30 days of discharge dropped from an average of 19 percent over the past five years to 17.8 percent in the last half of 2012, an improvement due in large part to penalties imposed by Medicare for poor performance and financial incentives paid by Medicare to providers to encourage better coordination of care after a patient leaves the hospital."
Continuing, "A number of pilot programs in Medicare and Medicaid have been started to reward quality, to encourage doctors and hospitals to coordinate care, and to lower costs. If enough of these experiments pan out, they could transform not only Medicare but the entire health care system."
Even as we speak, Congress appears to be planning to both increase and accelerate the penalties, a "doubling down" on reducing costs and improving outcomes. With early programs demonstrating success and ever increasing penalties for poor quality and readmission rates, providers are under severe mandate to take care of patients better after they are discharged, and provide care in the community that assures fewer need to be hospitalizeed in the first place.
Ankota's technology is used by providers of all sorts to Plan, Coordinate, and Deliver that care.