Hospital Readmission is the term used in a section of the Patient Protection and Affordable Care Act (PPACA) which states that in October of 2012, the government will begin to penalize hospitals for avoidable hospital readmissions by reducing their Medicare reimbursements by a designated percentage.
The penalty is expected to be as follows: 1% in 2012, 2% in 2013 and 3% in 2014.
What is the time frame that the Center for Medicare and Medicaid Services (CMS) defines as an avoidable readmission?
CMS defines the time period for avoidable readmissions as 30 days from the date of discharge. Under the law, if a patient returns to the hospital within these 30 days, the hospital will be penalized. After 30 days, the penalty will not apply. Therefore, most hospitals testing formal readmission plans will be interested in patients not returning for a minimum period of 30 days.
What are the conditions that are primarily considered an issue for avoidable readmissions?
According to www.CMS.gov:
• CHF (Congestive Heart Failure),
• AMI (Acute Myocardial Infarction) – heart attack,
• Pneumonia, and Secondary causes: diabetes and co-morbidity or multiple conditions.
The top three causes are consistently stated in research; the secondary causes fluctuate based on the research conducted.
What are the main issues that CMS has stated are the reasons for high avoidable readmission rates?
• Medication mis-management or non-compliance
• Failure to make follow up doctor appointments
• Nutrition mis-management
• Safety Issues
Aren’t these issues that the Home Instead Senior Care® network can assist with?
Yes! These are all services that local Home Instead Senior Care offices can offer. We can join the conversation with traditional RPN’s who are discharging patients to support them in getting a patient home safely and let RPNs know that we can provide services to help support these individuals when they return home.
What is the Home Instead Senior Care network doing around readmissions?
We are pursuing a partnership with a national hospital system to conduct a pilot program. This is a 6 month test to:
• Gain empirical data that demonstrates the network’s care will lower readmission rates.
• Gain knowledge on what plan of care (number of hours/services) is optimal to reduce readmission rates.
We are attending several national conferences centered on this issue to insert ourselves in the conversation and raise awareness of the network’s services.
We are creating materials related to a new program called Returning Home. These materials will be rolled out in phases so that they can be used at first to sell the network’s traditional services without a formal readmissions program (30 day/tracked plan of care). In later phases, once data is collected, additional materials will be created to include data from the pilot we plan to conduct (lessons learned from the pilot program).
If your loved one needs help at home post hospital visit, please call us at 925-280-9688.
Home Care Walnut Creek, CA delivering home care and elderly services to seniors in the Contra Costa area including Concord. Call us 925-280-9688.