Last year, two-thirds of eligible hospitals felt the blow of readmission penalties, which totaled $227 million, according to the Healthcare Financial Management Association. Since CMS announced it would enforce these regulations, hospitals have been searching for effective strategies to address the complicated factors involved with readmissions.
In late June, I will present at the HFMA National Institute Conference (ANI) in Las Vegas, speaking about the current state of health care and how hospitals can optimize their post-acute networks. In this session, I will discuss strategies and solutions for leveraging people and technology to reduce readmissions while promoting better health outcomes and improving the patient experience. My co-presenter, Josh Brewster from the University of Iowa Hospitals and Clinics, will share his organization’s journey toward decreasing readmissions, offering success stories, outcomes and lessons learned.
Currently, hospitals are engaging in several initiatives to limit readmissions. For instance, some organizations are pursuing mergers and acquisitions with the goal of keeping care under one umbrella throughout the continuum. The thought is that by strategically acquiring post-acute providers, hospitals can keep patients “in sight” during post-acute care. Unfortunately, this approach is costly and does not directly mitigate the drivers of readmissions.
Some hospitals have also begun forming narrow post-acute networks in which they utilize and perhaps even contract with the “best post-acute providers.” Unfortunately, few institutions are the “best” at caring for every diagnosis. In addition, this does little to raise the bar for other providers and it can limit patient care.
Several hospitals also have opted to increase their workforce to help lessen readmissions, hiring additional discharge planners and care coordinators and/or sending clinicians to follow patients. In fact, I recently heard about an acute-care hospital that increased its compliment of care managers over the last year from 12 to 40. Although adding staff can certainly enhance care coordination, most organizations do not have the necessary resources for such a strategy.
While these efforts can have an impact on readmissions, they do not go nearly far enough and they may not be sustainable. Another option that can have a more direct effect involves implementing technology that streamlines and automates discharge and care coordination processes, in addition to facilitating provider–provider and provider–patient communication within post-acute networks.
By leveraging technology solutions, health-care organizations like the University of Iowa Hospitals and Clinics are maximizing their human resources, enabling them to concentrate on the care and well-being of patients to successfully reduce readmissions and achieve better outcomes overall.
Wayne Sensor is a healthcare advisor and member of the Ensocare board. He has been recognized by government, political and industry leaders for achievements in quality, transparency, consumer engagement and wellness. Wayne is the former CEO of Alegent Health, a 10-hospital system serving Nebraska and Iowa, and Christus Schumpert Health System in Louisiana. Most recently, he was a partner at Leavitt Partners serving as the lead executive advising large health systems. Wayne earned a master's degree in business administration from St. Ambrose College and a bachelor's degree in business management from the University of Northern Iowa.