Tuesday, August 14, 2012

Studies Point Out Simple Solutions to Patient Readmission

Over the past week, numerous headlines have broken regarding one of the biggest problems in the health industry this year. Patient readmission is still a huge issue, but in almost every case, the culprit is lack of education and laziness. Sound harsh? Let’s look at the data.

“Several New York-area hospitals will lose millions of dollars in federal Medicare payments,” begins this WNYC report, “because too many of their patients keep coming back — and the government's tired of paying for it. “ Increasing numbers of hospitals are noticing a rise in patient readmission, and the blame seems to lie at the feet of those very facilities. HealthDay claims that

Results of medical tests done just before patients leave the hospital often go unread and are not acted upon, posing health risks to a significant number of patients… Close to half of the tests ordered on the day of discharge are never looked at again, [Enrico Coiera, director of the Center for Health Informatics at the Australian Institute of Health Innovation at the University of New South Wales] said.

"Some of these are unnecessary and represent a major opportunity to save on costs," he said. "Others are clinically significant, and should be followed up."

According to Coiera’s findings, nearly half of the test results ordered on the day of discharge are never seen by doctors. This puts patients at a severe disadvantage, and increases the likelihood of readmission.

However, some hospitals are firing back at those accusations. According to the WNYC report,

Some safety-net hospitals that treat large numbers of low-income patients tend to have higher readmission rates, which the hospitals attribute to the lack of access to doctors and medication these patients often experience after discharge. The analysis of the penalties shows that 76 percent of the hospitals that treat many low-income patients will lose Medicare funds in the fiscal year starting in October… Medicare disagreed, writing that “many safety-net providers and teaching hospitals do as well or better on the measures than hospitals without substantial numbers of patients of low socioeconomic status.”

What do you think? Will we see a drop in patient readmission any time soon? Are Medicare’s efforts helpful, or harmful? Tell us in the comments below.

Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at Pamela.Argeris@merrillcorp.com.

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