Care Transitions Continue to Be Hot Topic

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
Care Transitions Continue to Be Hot Topic

The data on hospital readmissions can mean both good and bad news, depending on your role in the healthcare continuum.

For patients, the news is good because hospital readmissions among Medicare patients have dropped to under 18%, down from 19% during the years 2007-2011 and 18.4% in 2012, according to analysis from the Centers for Medicare & Medicaid Services.

But if you’re an administrator at one of the more than 2,600 hospitals that were hit with lower Medicare reimbursements because of readmission rates, you likely have a very different opinion.

Medicare added readmission penalties for two additional conditions, which is one of the reasons for more widespread penalties. Medicare now monitors hospital readmissions for patients who have:

  • Heart failure
  • Heart attack
  • Pneumonia
  • Knee or hip replacements
  • Lung ailments such as chronic bronchitis

Hospitals face lower reimbursements for failing to reduce readmissions in any of the categories, so considerable attention is being placed on post-acute care.

Many health systems are more aggressively embracing care transitions – an area where home health organizations shine. In a recent post, I shared with you information about the care collaboration agreement between health system Mercy and Senior Independence that “seeks to increase the overall well-being of the patients through education and management of chronic diseases; reduce avoidable hospitalizations, hospital readmissions and emergency department visits; and decrease the overall costs of medical care.” Mercy serves a 20-county area of northwest Ohio and southeast Michigan with seven hospitals, an area that overlaps much of the service area for Senior Independence (SI).

I also ran across a program at Brooklyn’s New York Methodist Hospital that has reduced readmissions for patients enrolled in a post-acute care partnership by nearly 50%. The hospital is working with skilled nursing facilities and home health organizations that care for patients following discharge.

The importance of care transitions (and home health’s role in facilitating post-acute care for patients) will continue to grow. A White House blog notes that Medicare readmits have decreased by nearly 10% in 2013, compared to historical averages, resulting in the avoidance of 150,000 readmissions in 2012 and 2013.

How is your organization using technology to help reduce admissions in your service area? Let us know in the Comments section below.

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