Comedian Tracey Ullman always closed her show by telling her audience: "Go Home." But if she were a hospital provider discharging her patients, she might add, "And we're going to do everything possible to keep you there."
As federal payers consider reducing or eliminating payments to hospitals if their patients must return for care in 30 or 60 days, California researcher Jan Eldred went looking for programs with creative transition solutions, so discharged patients can remain safely out of the hospital.
She found nine, from Boston to San Diego, and chronicled their success in "Homeward Bound: Nine Patient-Centered Programs Cut Readmissions."
The nine projects include:
"Hospital readmissions can be significantly reduced using straightforward strategies that are inexpensive compared to hospital care," says the report. According to findings from some of the demonstration projects she included, up to half of all readmissions can be prevented.
The report was published by the California HealthCare Foundation and was written by Susan Baird Kanaan.
"New Medicare rules are coming, and everyone knows they're coming," which will reduce payments to hospitals whose patients must be readmitted within 30 or 60 days, acknowledges Eldred, the foundation's senior program officer who selected the nine programs from about 20 innovative health system strategies.
"We want organizations to know that there are health systems out there that have figured out how to do this already, and that there are things they know do work. They don't have to come up with something from scratch.
"That's the premise on which this report was prepared. We want organizations to know that there are programs that have figured how to do this, to keep patients from having to return to the hospital," Eldred says.
Eldred's report listed four stages of care that allow for effective intervention to reduce readmission:
Some of the innovative programs were launched as long as four years ago by organizations grappling with capitated rates in their health plans while others tackled the problem as an experiment. In all cases, however, leaders said the most important goal was to improve care.