September 14, 2012 by admin ?
Filed under Blog
On Oct 1st, Medicare will begin cutting payments to hospitals where too many patients are readmitted within 30 days of being discharged.? The Medicare Payment Advisory Commission (MedPAC) reported that in 2005, 17.6% of hospital admissions resulted in readmissions within 30 days of discharge.?
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Too many people are returning to the hospital.
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These transfers can increase the risks to the patient including delirium, medication errors, falls, and infection. Medicare, Medicaid, and private insurance pay out hundreds of millions of dollars each year in the process.? The majority of these rehospitalizations are preventable according to most studies.? Health care profesionals believe that the high readmission rates for patients ?are due to two main factors: ?inadequate relay of information by hospital discharge planners to the patient and poor patient compliance with care instructions.? With these changes in Medicare, hospitals should be taking steps to address this issue even though the initial penalties are relatively small and only apply to ?heart failure/attacks and pneumonia. This will likely change over time and so will the mindset of hospital administrators.
The hospitals need to improve the discharge process and keep a closer eye on the patients after they leave. ?For those patients that are discharged back to a nursing facility, the hospital will have easier time. The facility has trained staff that help ensure that the patient complies with the care instructions and avoid returning to the hospital.
For those patients returning to their homes and not having any help from family or friends, the hospitals should suggest that the patient involve an outside agency such as NurtureCare to help with care.? This can help ensure that the patient is able to follow the instructions given by the discharge staff at the hospital and begin the process of the return to healthfulness. ??The agency can refer a caregiver that will help with the activities of daily living as well as provide companionship. ??This service is paid for out of pocket by the patient and is unfortunately quite expensive.? There are obviously many patients who can?t afford to have a caregiver help them at home.? This is going to make the hospitals? job a lot more difficult.? The hospital would like someone to go home the patient and make sure they are all set up to get better.? It turns out that In most markets in the United States there are many many agencies providing private duty services. The hospitals have locked out the agencies from soliciting business in the hospitals.? As this new rule takes affect, the hospitals will find that they have patients that need private duty services. Some can afford the services and some of them can?t.? For those patients that cant afford the services, the hospitals should setup an arrangement with the agencies either informally or formally whereby ?the agencies would be willing to take certain patients Pro Bono with the understanding that they would get either access or referrals from the hospital.? ????
This arrangement will be a benefit to the patients, the hospitals and the agencies.? The agencies? involved in homecare are in the business of helping people.? This would give them the opportunity benefit of helping their community.?
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