Aligning Reimbursement To Reduce Avoidable Hospital Readmissions

Maryland’s Hospital Preventable Readmissions program rewards efforts that reduce hospital readmissions while improving care quality and decreasing cost. Dianne Feeney, associate director of quality initiatives for the Maryland Health Services Cost Review Commission (HSCRC), describes HSCRC’s response to hospitals that claim they can’t afford the empty beds that result from programs like these, as well as processes to help ensure that higher-risk patients are not refused admittance to hospitals. She also explains how partnerships with “siloed settings” — nursing homes and home health providers — can reduce common errors that occur during patient handoffs.

Case managers and advanced practice nurses in Aetna’s Transitional Care pilot have also successfully partnered to reduce readmissions. Dr. Randall Krakauer, national medical director, Medicare at Aetna, describes the key focus and the complementary roles that reduced 90-day readmissions by 25 percent. Dr. Krakauer also weighs in on the pros and cons of bundled payments, and why incentives alone will not significantly impact avoidable readmissions.

Feeney and Dr. Krakauer examined how to structure programs to reduce avoidable hospital readmissions, including the alignment of financial incentives, during the December 2, 2009 webinar, Aligning Reimbursement To Reduce Avoidable Hospital Readmissions.

Length: 5:03 minutes (this sound byte features Dianne Feeney)

Length: 5:06 minutes (this sound byte features Dr. Randall Krakauer)

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