Reduce Readmission Rates or Pay a Penalty:
12 Effective Strategies

Monday, July 30th, 2012
This post was written by Jackie Lyons

Beginning in 2013, CMS will penalize hospitals for excess readmission rates, starting with those related to heart failure, acute myocardial infarction and pneumonia. To combat this, hospitals are more focused than ever on reducing avoidable utilization. Programs include care transitions, post-discharge support, medication adherence, telehealth and more.

HIN’s 2012 Reducing Hospital Readmissions e-survey conducted in February 2012 documented the highest rates of targeted programs to reduce readmissions in the survey’s three-year history. Respondents also listed effective strategies they utilize to keep readmission rates down and penalties to a minimum:

1. “Calling [the discharged patient] within 72 hours, and engaging the patient post-discharge.”

2. “Transition coaches having a face-to-face appointment with a patient while still in the facility.”

3. “Medication reconciliation, care transitions: outreach once a week for four weeks, and close monitoring of high-cost claims.”

4. “Education and collaboration of plan of care between hospital, long-term facilities, home health and hospice agencies.”

5. “Engage in group physical activity sessions that focus on the physical, social and emotional well-being dimensions.”

6. “Early referrals from discharge planners so we can assess the patient for safety in the home and provide safety modifications and training.”

7. “Calling and reminders. Checking on regular medication adherence and telephonic health coaching with triage to the nurse practitioner in case of requirement for medical management.”

8. “Front-loading our visits, use of telehealth, fall risk assessments, order physical therapy.”

9. “Follow-up appointment within 14 days of discharge.”

10. “An electronic HIPAA-compliant server that uploads patient data for doctors, nurses and patient to see their glucose levels, blood pressure, and weight so these can be managed before they get out of control.”

11. “Providing more acute services at nursing home.”

12. “Close integration with multi-disciplinary team.”

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