From a recent article by Angela Haupt on the US News Health web site: Hospitals are focusing attention on reducing redmissions and are finding early success. What's driving these programs and what is needed to implement them on a large scale basis?
Stemming from a US News & World Report forum on healthcare titled "New Strategies for Preventing Readmissions," part of the U.S. News Hospital of Tomorrow Forum, moderator Steven Sternberg warned the audience that it would be a "complicated, solutions-based" session. And, if audience members needed to stand up during the forum, added Sternerg, "There will be no penalties for readmissions today." Sternberg is also U.S. News's Deputy Health Rankings Editor.
Why all the focus on reducing readmissions?
That's easy, and unless you haven't been paying attention, you already know that hospitals face significant penalties for higher than acceptable readmission rates for certain diseases. US News & World Report reports that 2225 hospitals will pay such fines this year alone.
Says Joel T. Allison, president and CEO of Baylor Scott and White Health, "We don't get any bonus for high-quality care, we only get a penalty -- all you can do is lose."
The penalties increase each year and the number and types of diseases that are targeted are scheduled to grow as well. The message is clear: some diseases are just better taken care of outside of the hospital (and in the home in particular), so CMS, the country's largest payer, is done paying for hospital treatments when other approaches are proven to be both more effective and less costly. All CMS has really done is to provide the financial incentives to assure that these diseases are treated proactively and result in better outcomes, fewer hospital admissions, and lower overall costs.
Providers already know how to care for these conditions, they just lack the "distribution" of services outside of their own hospitals. "That can be remedied quickly usinig Care Coordination technology like ours," says Ankota CTO Ken Acccardi.
Many hospitals are employing new models to address their readmissions problems, but many aren't. According to the Commonwealth Fund, more than half of all hospitals have no program whatsoever, a disturbing fact given that these penalties--and their very clear message--have been expected for some time. Of those hospitals that have implemented programs, several participated in the Forum and shared their early successes.
Allen S. Weiss, president and CEO of the NCH Healthcare System, is one of those who shared their success and advice on how to make avoidable readmissions programs work. His hospital is working to reduce acute care overall readmissions by 10 percent by the end of fiscal year 2013. "I think the secret sauce, if you will, is a very hearty IT system." Weiss went on to describe how they use technologies to anticipate risk and direct care to patients while still in the hospital, which ultimately reduces the risk of complications at home. Many other programs combine such an approach with effective follow up care by home health services such as follow up phone calls and nursing visits from home health organizations.
While nearly half of hospitals have started some sort of program to reduce readmissions, they typically lack technology and staff to allow them to scale. That's where Ankota comes in, providing Care Coordination technology that assures productive transitions from hospital to home, and coordination of services among multiple providers. While the hospital, in many cases, will be the one to drive these programs (since they stand to suffer the penalties), they have to rely on "Ecosystems" of providers to coordinate care and carry out healthcare services according to plans that are known to improve patient outcomes.
To learn more about how Ankota helps providers better manage Care Transitions and coordinate care among providers, contact us using the button below