In less than two weeks, CMS will begin reducing a hospital’s Medicare reimbursements by as much as 1% if the hospital’s readmission rates are too high. This reduction is part of a program authorized by the Affordable Care Act called the Hospital Readmissions Reduction Program. You can read more about the program CMS’s website.
Nearly 1 in 5 of all Medicare beneficiaries is readmitted within a month of discharge, and CMS’s new program aims to reduce that number. CMS will be using a hospital’s readmission rates for heart attack, heart failure, and pneumonia to calculate the hospital’s reduction, or what CMS calls the “readmission payment adjustment.” Until now, hospitals have had little incentive to follow up on patients after discharge. Some hospitals even welcomed readmissions because a second stay meant additional revenue. With this new program, hospitals have a significant incentive to prevent patients from returning for another stay and now many hospitals are focused on how to reduce readmission rates.
It is clear hospitals must have an effective discharge planning process in place. Hospitals should also communicate with post-acute providers to ensure a smooth transition. However, hospitals may want to consider going high-tech. Remote, home-based monitoring systems are available so hospital staff can monitor a patient’s data without the patient returning to the hospital and without costly time spent communicating by phone. Proponents of such systems argue that they provide continuous and real data to physicians and nurses, which is more convenient for patients and less costly for hospitals. One health plan used remote monitoring systems to reduce its patients’ readmission rate for heart failure by 44%.
Our Insight. Your Advantage. Hospitals should consider all avenues to reduce readmission rates. While the traditional methods such as discharge planning are absolutely critical in ensuring patients do not need to return, hospitals should consider newer and more technologically advanced methods as well. Remote monitoring could be what prevents your hospital from receiving reimbursement cuts under the Hospital Readmissions Reduction Program.