Many of us have either spent time hospitalized or have spent time with a loved one who has been hospitalized. For those of us who have been in either position, the last place we want to be after being discharged from the hospital is right back in it. However, sometimes our health necessitates a return visit. Hospitals provide great service and care to their patients, but they also recognize the value of individuals not quickly returning for the same issue.
According to a study published in the New England Journal of Medicine, approximately 1 in 5 Medicare beneficiaries reported being readmitted to a hospital within 30 days of discharge between 2003-2004. While hospitals have long worked on their own to minimize readmission rates, they are receiving some external incentives to reduce these rates.
Through the Affordable Care Act, a Value-Based Purchasing Program with Medicare will be linking payment to quality outcomes of hospitals. Beginning in October 2012, hospitals will receive financial penalties in regard to their Medicare reimbursement for having too many individuals readmitted soon after their discharge. Kaiser Health News released an article recently highlighting these Medicare based financial changes. Here in Missouri, several institutions in the St. Louis area and institutions statewide (MO is listed on pages 36-38) will begin feeling that impact.
Dr. Carolyn Clancy highlights this issue in her recent Agency for Healthcare Research and Quality advice column: Navigating the Health Care System: Helping You Avoid Return Trips to the Hospital. Through a variety of tools, hospitals can work to avoid financial penalties that are being applied based on readmission rates for specific diagnoses.
One of the greatest tools that hospitals can use to reduce return readmissions is the creation of a unified care team. Many hospitals are looking into care transitions programs or discharge planning teams. Community organizations and programs, as well as the patient and their family and friends, can help to create a holistic team centered on improving the health of the patient. One document to be used upon discharge includes a document from the Agency for Healthcare Research and Quality, the Going Home Guide.
In Missouri, there are several self-management programs and physical activity programs offered by partners of the Missouri Arthritis and Osteoporosis Program and its seven Regional Arthritis Centers. These programs may be a good starting point for an individual upon discharge from the hospital. Programs like the Chronic Disease Self-Management Program can help an individual manage the conditions that may have led to a hospitalization, been diagnosed during their hospitalization, or been made worse as a result of hospitalization for another reason. In working with family, friends, community partners, and a hospital team, an individual can improve their health as well as their ability to stay out of the hospital once they leave it.