As the Affordable Care Act implementation continues to take effect, hospitals across the nation must either reduce their readmissions or pay the price for not doing so—but not many have been significantly successful so far, and a lot of that has to do with a lack of standardized procedures for care coordination, finds a study published in the Journal of the American College of Cardiology in July.
Most hospitals have taken preliminary steps to avoid readmissions of patients with heart failure or acute myocardial infarction, the study’s authors note, but many important practices, such as alerting outpatient physicians of a patient’s discharge within a 2-day timeframe, are only infrequently in place.
Hospital readmissions are estimated to cost Medicare $17 billion per year—an expense that the ACA seeks to curb through its provision that will soon allow Medicare to penalize hospitals for patients readmitted within 30 days of their discharge. In cases involving patients with heart failure, heart attacks, and pneumonia, hospitals with “excessive” readmission rates will get their Medicare reimbursements docked starting in fiscal year 2013. Reimbursement cuts will get progressively steeper through 2015.
In seeking to avoid these cuts to Medicare reimbursements, many hospitals are partnering with post-acute care providers, among which are skilled nursing facilities and even assisted living communities. The researchers found that 67.9% of the hospitals studied were already partnering with home care agencies and nursing homes to reduce admissions, but there’s still room for more.
“Such partnerships could be important if formulated correctly and if they did increase communication, planning, and then services for discharged patients at home,” says Dr. Elizabeth Bradley, one of the study’s authors.
In addressing the problem, the study’s authors said it might help to standardize the systems for reducing hospital readmissions.
“Infrequent use of practices shown to reduce the rate of hospital readmission for heart failure may be attributable to a number of factors, including insufficient resources and constraints on staff time,” they said. “It may also reflect the complexity of coordinating efforts among physicians, pharmacists, nurses, and many of the ancillary staff to achieve a smooth discharge.”
Ultimately, there is “significant opportunity for continued improvement” in communication and care coordination, they conclude.
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Written by Alyssa Gerace