Archive for February, 2009

Patient Education Cuts Hospital Readmits by 1/3

February 5th, 2009 by Melanie Matthews

AHRQ finds that educating patients before they leave the hospital reduces readmissions, ED visits and saves money.

From the AHRQ study:

Patients who have a clear understanding of their after-hospital care instructions, including how to take their medicines and when to make follow-up appointments, are 30 percent less likely to be readmitted or visit the emergency department than patients who lack this information.

This backs up what we learned from a recent HIN survey on strategies to reduce hospital readmissions — that provider partnerships, education and communication do keep patients out of the ED and the hospital. Most of the survey’s 200 respondents believe that coordinated planning of a patient’s care following a hospital or nursing home stay can greatly impact health outcomes, likelihood of readmission and/or emergency room visits, as well as cost to patients, providers and insurers.

Some key HIN survey results:

  • Nearly 76 percent of respondents say readmission reduction attempts are first aimed at the seriously ill and/or those with multiple comorbidities. Patients with caregivers are given priority by nearly 50 percent of respondents, and those suffering from dementia targeted by 26 percent.
  • Of 54 hospital survey respondents, slightly fewer than 70 percent are actively working to improve their ratings in this area. Half of remaining hospitals say they will address this in the year ahead.
  • Nearly 60 percent say they see a reduction in readmissions, with just under 10 percent saying there’s no change in rates and 32 percent saying their efforts are too new.
  • Eighty-four percent provide departing patients with improved discharge instructions.
  • Almost 60 percent schedule follow-up visits.
  • Forty-eight percent offer telephonic support.
  • Other ideas: Home Visits, Fall prevention programs; Relationships with post-primary providers; Increased home health referrals; Home health monitoring; Partner with providers to ensure follow-up visits; Case management review of readmission stats by physician, diagnosis, etc. Incorporating prevention at the public health level.
  • 13 ways to speed patient payments

    February 2nd, 2009 by Melanie Matthews

    Even without EMRs, some basic QA can boost revenues and reduce bad debt, suggested Beacon Partners during HIN’s webinar last week on improving patient collections:

  • Assess your organization’s delivery from patient’s access — that initial contact with the patient — to see if you done everything you can to determine if the patient has insurance, what the policy will cover and how any balances will be satisfied.
  • Engage the patient early. This tactic has proven to be the most effective; it decreases the anxiety of the patient’s visit, it fosters recovery, it creates an advocate in the community for you and also secures the payment.
  • Educate staff on upfront collection policies, providing scripts and role-playing if necessary.
  • Install an automated verification system. Even though the technology is in its infancy, it is proving to be the single most important IT to boost revenues.
  • To anticipate and support requests for cost estimates from patients and payors, identify the five to 10 top procedures within your organization from the HIN Department and get a cost basis on procedures with and without complications.
  • Clean up your registration process to avoid delayed reimbursements. Typically, error rates during a registration process range from 30 to 50 percent.
  • The majority of bad hospital debt comes through the ER. Work with the ER management team to develop an ED discharge policy and a work flow. Ideally, have a designated discharge area where the nurse escorts the patient back to a designated area.
  • Offer financial counseling not only in the emergency room, but during pre-registration. Pre-registration can identify any patients that are self-pay and if necessary, the financial counselor can work with them to set up satisfactory payment arrangements, possibly get them some Medicaid assistance through the use of Medicaid eligibility company.
  • In a declining economy, patients forego elective procedures, which may create slack in your schedule. Compress that slack and use it to build revenue. Take advantage of down time in your schedule and get patients in when they’re hurting. If you wait a day then the pain may go away. Determine how long it takes for that patient to enter your system. Your practice management or scheduling system should be able to identify the third available appointment for that visit. So if a patient calls in today and wants to come in on Thursday, and you’re not available for Thursday, when is the next free appointment or the third one?
  • Reconciling your charts with your appointment list can increase your revenue by about 5 percent.
  • Use EMRs to increase revenue by 24 percent and avoid the seven critical problems related to the handwritten chart.
  • Educate yourselves about health savings accounts. Only 75 percent attempt to collect a co-payment at the time of visit and only 14 percent collect absolutely nothing from patients at the time of visit and they bill the insurance carrier. Providers can no longer afford to do that.
  • Train all staff on policies and procedures. Technology is only as good as the people using it and the people using it are only as good as how they use it. So if you have too many workarounds in place, you’re losing revenue somewhere. Make sure staff understands the legal ramifications of each person’s visit.