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Preventing Hospital Readmissions Presents Financial Paradox

Rene Letourneau, for HealthLeaders Media, June 10, 2013

"Medicare is looking at overall readmissions and paying based on that, but when we got into the business of preventing readmissions we were completely in a fee-for-service environment. We did it because it is the right thing to do for our patients," he adds.

Through its participation in the RARE Campaign, Regions Hospital in St. Paul, a 454-bed facility that is part of the HealthPartners care system, experienced a 15% drop in its readmission rate in 2012 compared to 2009 and 2010, says Josh Brewster, director, care management.

"This is equivalent to preventing over 378 readmissions in 2012 alone," Brewster says.

"We have come to realize there is no silver bullet to preventing readmissions," he says, noting that the hospital is focusing on efforts such as interventions targeting micro-populations of high-risk patients, improved collaboration and coordination among all care settings, building a culture focused on readmission risks, and closely monitoring non-elective readmission rates across all patient populations and CMS target populations.

"Although one of our measures of success was to minimize the Medicare penalties, we see this work as being about excellent patient care and ensuring patients' care is coordinated," Brewster says. "The overall cost of care for the larger health system and improving patient care are more important to us than any impact fewer admission may have to our bottom line."

Brewster's comment echoes what I've heard many times recently. Many healthcare leaders know preventing readmissions may hurt their organization financially—at least in the short term—but are still pushing their teams to make immediate strides on this important quality measure because it's just the right thing to do.

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