The Ankota Healthcare Delivery Management Blog

Avoiding Readmissions: Incentive for ACOs, Home Health and Hospitals

Posted by Will Hicklen on Dec 16, 2011 9:09:00 AM

NEJM Rehospitalization Rates

With 20% of patients being readmitted to hospitals within 30 days of discharge--and 34% being readmitted within 90 days--readmission rates have become a leading measure of the quality of a hospital's care (data: New England Journal of Medicine, 2009). The Affordable Care Act attacks this issue head on with financial penalties amounting to reductions in payments of 1-3%. Constant offenders will see penalties rise further. Considering the fact that most hospitals run on margins that range from negative to 3%, it is likely that this penalty will render most hospitals insolvent.

This is a mandate to send patients home for successful recoveries and save the Medicare system tens of billions of dollars in the process. Private insurers will follow the same model, forcing additional savings to the system in the range of tens of billions of dollars as well. 

There is no doubt whatsoever that the hospitals are in crisis-mode. They basically have a year to get their act together and get this readmissions problem under control or face severe financial penalties. 

What is the cost is this frequent rehospitalization? According to the New England Journal of Medicine it costs CMS--the taxpayers-- $17.4 BILLION in 2009 alone. Tremendous opportunities exist for those who can help hospitals reduce the rate at which people have to be readmitted.

One of the greatest opportunities to mitigate readmissions lies with home health care and related companies. The companies that provide the nurses, aides, therapists, equipment, medications and supplies for care that is delivered outside of the hospital -- what Ankota calls the "Home Care Ecosystem" -- are uniquely suited to be the primary delivery model for the care that keeps patients at home, where they recover faster, better and they are happier. 

This economic alignment is giving rise to Accountable Care models, which is already forcing hospitals to cooperate with providers in the Home Care Ecosystem. Sigificant pressure is on them to operate efficiently, cooperate with other providers, and be accountable for patient outcomes.

Ankota's web-based technology enables Care Coordination among hospitals, Accountable Care Organizations, and the home care ecosystem, and instantly helps them operate their businesses more efficiently. Contact Ankota to learn more or request a demo

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NEJM reshospitalization rates

Topics: Health Care Reform, Care Coordination, transitional care, Will Hicklen

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About Ankota

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Reeadmisison avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact Ankota.

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