The program was a success at reducing 30-day readmissions, by 48% compared with rates before the intervention.
The hospital, however, lost an average of $751 in revenue on each patient.
"While we are not-for-profit entities, at the end of the day we still have to make payroll," Stauffer said in a telephone interview. "We have bills to pay and have to maintain enough margin to pay for capital expenses, build new facilities and keep them updated, and that's got to be paid for by somebody."
In an accompanying editorial, Mitchell Katz, MD, head of the Los Angeles County Department of Health Services, called Stauffer's report "illuminating."
"The cost-analysis by Stauffer, et al, points to a widespread problem in American medicine. Reimbursements are generally linked to episodes of care: visits, hospitalizations, treatments and procedures. Reimbursements are rarely provided for preventing negative outcomes.
"As long as this is the case, the American system will produce more visits, hospitalizations, treatment, and procedures," Katz wrote.
Because preventing readmissions is the right thing to do, and because Baylor can afford the program, the intervention will continue, Stauffer said. Garland only admits 300 heart failure patients a year, "so it probably isn't going to bankrupt us, but it speaks to the larger issue. You really want hospitals to focus on this, and expand it beyond heart failure...and when you do I think you do run the risk of undermining the financial stability of a lot of these systems."