As regional payers and providers take the first steps to begin working together in the era healthcare reform, one area they can start with is the issue of readmissions.
At Albany Medical Center in Albany, N.Y., a one-year pilot with Capital District Physicians Health Plan brought a 40 percent reduction in readmissions for the insurer's Medicare Advantage members.
Before the pilot, readmission rates for Capital District Physicians' Medicare Advantage members at Albany Medical Center stood at around 17 percent. A year later, that stands at 10 percent.
In the pilot, patients meet with a registered nurse case manager from Capital District Physicians prior to leaving the hospital. The nurse manager followed up with patients by calling them at home to remind them of their discharge plans, any medications and upcoming appointments. More than 90 percent of Capital District Physicians' Medicare Advantage members who were hospitalized participated in the program.
"The goal of our teams is to ensure that patients receive the very best care while they're in the hospital and do not need to return after discharge," said Bruce Nash, MD, chief medical officer for CDPHP, in a press release. "This pilot is a major step in the right direction."
The pilot was a double boon for the hospital, said Steven Frisch, MD, Albany Medical Center's executive vice president of integrated delivery systems and hospital systems, in a press release, because not only were readmissions trimmed, the hospital used the pilot as an opportunity to focus specifically on transitions of care.
"Effective planning and communication with patients, caregivers and post-acute providers is key to reducing potentially avoidable readmissions," Frisch said in the release.
This story is based on a report appearing on Healthcare Payer News.