In a year from now, in October 2012, Medicare will begin penalizing hospitals when their elderly patients, once discharged, are readmitted within 30 days. The penalty will be equal to 1 percent of their total Medicare billings and will rise to 2 percent in 2013 and 3 percent in 2014.
A report on hospital readmission rates released last week by the Dartmouth Atlas Project found that readmission rates haven’t improved since 2005, due in large part to uncoordinated and inadequate follow-up care by physicians and the discharging hospital.
The report, “After Hospitalization: A Dartmouth Atlas Report on Post-Acute Care for Medicare Beneficiaries,” says 1 in 5 Medicare patients return to the hospital within 30 days of discharge. www.dartmouthatlas.org/downloads/reports/Post_discharge_events_092811.pdf
The annual cost of avoidable readmissions stands at $17 billion, according to the U.S. Centers for Medicare and Medicaid Services (CMS).
“Hospitalized elderly are some of the nation’s sickest patients, and they enter the hospital with the hope for not only short-term improvement, but also long-term benefit,” the report states.
As a country, we need the cost savings, and we’ll take it. But what does this mean to each of us individually? I hope it means the hospital revolving door stops spinning for our parents.
Skeptical, are you? I don’t blame you. The healthcare industry has been trying to reduce what it calls “readmits” for many years.
My own experience exemplifies the lack of success: Between October 2009 and January 2010, my mom was shuffled back and forth between one hospital, two rehab centers and her own home eight different times.
But I believe this time might be different. I want to believe. Financial incentives aside, hospitals and other healthcare providers are beginning to work in tandem on “care-transitions” programs as outlined by the CMS.
The CMS’s Community-based Care Transitions Program is funding pilot programs around the country designed to improve care transitions for high-risk Medicare patients. This effort is part of the Partnership for Patients, a public-private partnership to reduce harm and improve care transitions.
The Dartmouth authors believe that these programs can positively affect short-term outcomes. But there's more. “The greater question is how they can contribute to, and be effectively aligned with, broader efforts to improve care integration, coordination and accountability across the full continuum of patient care.”
It’s a question I have as well. These care-transitions programs all contain the same elements: follow-up telephone calls from hospitals, better care coordination between physician, hospital, rehab center, nursing home, and Medicare-paid home healthcare services, and better record-keeping.
That’s a good start.
But what’s missing as far as I can see is a commitment to on-going home care services that provide companionship, help with daily activities, and medical assistance for meaningful periods of time.
These are the type of services that BrightSar provides, with qualified, compassionate caregivers who make sure your parent makes and keeps the follow-up doctor’s appointment and is taking his or her medication. Our caregivers also make sure your parent is eating right and getting the right kind of exercise or activity.
In short, private duty agencies like BrightStar can coordinate all aspects of the post-hospital care plan and make sure it is followed. But what gives us the most joy is knowing your mother or father is on the mend and looks forward to his or her day.
And in the best-case scenarios, private-duty home care assistance will already be part of your parents’ daily regime, which can, in fact, prevent that unfortunate and unexpected hospital stay. With each of our cases overseen by a long-time Registered Nurse, BrightStar is looking at our clients holistically. In many cases, we are the care coordinator.
“Care coordination needs to be a continuous process that begins before illness warrants hospitalization, continues when hospitalization is necessary, and seamlessly moves back into the community,” according to the report. “For many patients, particularly for those with chronic illness, the episode of care has no definite end. Innovations in care coordination need to further develop lifelong models of longitudinal care.”
I couldn’t agree more.
am.gattari@brightstarcare.com; 586.279.3610
No comments:
Post a Comment