A new survey examining how U.S. hospitals are addressing the Centers for Medicare & Medicaid Services 30-day readmission penalties found that most facilities agree on what core strategies work the best for reducing preventable readmissions.
The survey, conducted in September 2013 by home healthcare delivery provider Amedisys Inc. and HealthLeaders Media Intelligence Unit, also revealed that many hospital leaders agreed on the major reasons behind preventable readmissions.
According to the survey of 106 senior leaders at 44 U.S. health systems, 73 percent of those polled cited a lack of preventative care and monitoring of patients with chronic conditions as a major cause of preventable readmissions. Additionally, 67 percent cited a lack of coordination between hospital discharge and physician follow-up, and 57 percent cited poor accountability for who is responsible for patient follow-up as major reasons driving readmissions.
[See also: Readmission costs even higher than suspected.]
The number-one strategy hospitals adopt in order to lower preventable readmissions is partnering with home healthcare organizations (73 percent of respondents), according to those surveyed. Additionally, 69 percent cited scheduling follow-up visits with primary care physicians as a major strategy, and 64 percent cited partnering with long-term care and skilled nursing facilities.
Michael Fleming, chief medical officer at Amedisys, explained that while many of the hospitals said that their number one strategy to lower readmissions is to partner with home healthcare organizations, 40 percent of those surveyed said they still have not found the right home healthcare partner.
"The realization is that care coordination is a problem whether or not there is a readmission penalty," said Fleming. "Patients are sent home with no coordination for what happens to them after they are discharged. We have to continue treating whatever the problem was in the first place. There needs to be seamless communication between what happens in the hospital and what happens after."
[See also: Readmissions penalty presents a business opportunity for home care companies.]
Fleming cited medication errors as a major issue for patients when there is inadequate communication or care coordination.
"Some patients are on 13 different medications, and often the medication lists in the hospitals and in post acute care offices do not match up,” he said. “It goes back to communication gaps."
The study cited a specific example of a western Pennsylvania hospital at which care coordination did reduce avoidable readmissions. Monongahela Valley Hospital partnered with its post-acute care partners (which included a skilled nursing facility and a personal care home) in 2011 to implement a number of strategies aimed at reducing readmissions. The collaborative was able to reduce its heart failure readmissions rate from 27 percent to 14 percent in one year, according to the report.