Preventing  Hospitalizations

There is little doubt that the Medicare debate currently going on in Washington will not (and should not) subside anytime soon. With the Medicare Trust Fund expected to be depleted by 2024, it is critical that steps are taken to preserve the value of the program.

Understanding the costs associated with the Medicare program provides insight into areas for targeted expense reduction. The number of hospital readmissions is one such area and one that is featured in The Patient Protection and Affordable Care Act or “Health Care Reform”.

High hospital readmission rates are a major concern for patients, families, health care providers, policy makers and payers. In fact, beginning 10/10/2012, hospitals will be penalized one percent of the Medicare reimbursement if hospital re-admission rates are excessive.

The statistics behind the concern:

• Nationally, one in five (20%) of Medicare seniors is readmitted to the hospital within 30 days of discharge. In Texas, the readmission rate is closer to 35%.

• 90% of the readmissions are unplanned.

• An estimated 40-75% of the re-admissions are avoidable.

• The cost of readmissions was projected to be $17.4B in 2004.

• Half of the patients re-admitted had not seen a primary care physician post discharge.

The reasons that patients are being readmitted have been well studied and documented. The readmission dilemma is a complex issue in a complex system.  Unfortunately, there is not a singular solution. Patients, families, hospitals, skilled nursing facilities, home health agencies and other post-acute providers must work together and aggressively to achieve success. We are all accountable individually and collectively.

Home Therapy of Austin, LLC is working aggressively to reduce the number of patients that return to the hospital while in our care. Future blog posts will focus on the generally accepted causes and our efforts to address the causes.