Centers for Medicare & Medicaid Services (CMS) required health systems and hospitals to reduce 30-day readmissions rates. All hospitals that did not reduce their 30-day readmission rates would be penalized. In 2012, CMS reduced Medicare payments by up to 1% (totaling $280 million) to more than 2,000 hospitals that failed to stay under the readmissions ceiling.
Parkview Health, a Talyst customer for over 10 years, successfully reduced their readmissions rate for its eight hospitals by 35%. That’s an increase from 11.2% in 2008 and 7.3% in 2011. According to an article in Pharmacy Practice News, “Parkview Health Cuts Readmissions, Keeps CMS at Bay,” the potential financial hit was a huge driver for this change.
Reducing readmissions start at admission,” Dr. Johnson said. He explained that Parkview’s program begins by identifying incoming patients who might be at risk for readmission from congestive heart failure, diabetes, pneumonia, acute myocardial infarction or chronic obstructive pulmonary disease (COPD). Other high-risk indicators include patients who had been admitted during the previous 30 days, those with multiple admissions during the past six to 12 months, or those presenting with other high-risk demographic and clinical indicators.
Once such a high-risk patient has been identified, care transition nurses are alerted and meet with the patient within 24 hours of admission. These nurses, who are former home health care RNs, seek to establish a trusting relationship with the patient and family or caregiver. “As you assess the patient, you can see all of the things that you could maybe do for this patient to prevent the readmission,” said Joni Hissong, Parkview’s director of care coordination. “Maybe they don’t have transportation back to their follow-up appointment. Maybe they really couldn’t afford the medication [they need] because they don’t have prescription coverage.” During the hospital stay, the transition care nurses join a collaborative care team with a hospitalist or cardiologist, inpatient case manager and the bedside nurse. Depending on the patient’s needs and condition, other specialists may join the team, such as a dietitian, pharmacist or behavioral health clinician. Team members make the rounds together to ensure everyone shares the same understanding of the patient’s needs and nothing slips through the cracks. Tara Jellison, PharmD, Parkview’s clinical pharmacy manager, said pharmacists on collaborative care teams may help select antibiotics and often adjust medication dosing requirements. “They help make sure that all the pieces of the puzzle are in place for the best care of the patient.
Parkview is an amazing example of how to reduce hospital readmissions. They are a long-time Talyst customer and have implementing our pharmacy automation for years, including AutoPharm and AutoCarousel HD. As mentioned in the article, medication management has been very helpful in reducing hospital readmissions. It ensures patients are adhering to their medication regiments after they are discharged and are not readmitted before 30 days. Not all health systems are as proactive as Parkview in improving their hospital readmission rates, which makes Parkview’s reduced readmissions rates even more commendable.
Have you reduced hospital readmissions? What method are you using to ensure this? Are you using any type of pharmacy automation technologies?