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Preventing Hospital Readmissions Presents Financial Paradox

Rene Letourneau, for HealthLeaders Media, June 10, 2013

"I think everyone in healthcare knows that preventing avoidable readmissions is something we need to improve upon because for the patient. Any time you have to be rehospitalized, it's a negative," says Barbara Possin, vice president of strategy and quality at Essentia Health, a Duluth, MN-based integrated health system that spans three states.

"We know this is where we need to go in the future, and our executive leadership team believes strongly that this is the right way to go… To say it impacts our bottom line today isn't going to help us in the future," she adds.

Possin believes that reimbursement structures will eventually reward providers more for higher-quality care as the industry continues to move toward accountable care models. Essentia is already participating in a number of programs that provide financial incentives for quality improvement, she says.

"We have contracts with certain payers around meeting quality measures, and those financial relationships help to ease the transition."

Jeffrey Lyon, MD, patient quality officer for Essentia Health's east region, reports that the health system has more than met its goals for preventing readmissions.

"Our overall rate of readmissions has gone down significantly. The goal was to decrease readmissions by 20% using 2009 as a baseline. We're down 22% overall," Lyon says.

To achieve these results, Essentia has taken steps to provide better care transition at the time of hospital discharge, improve medication reconciliation, and conduct follow-up calls with patients to ensure they understand their care instructions and have an appointment with a primary care doctor within five days of discharge, Lyon says.

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