Mar 10, 2017
Regulations from the Centers for Medicare and Medicaid Services (CMS) force hospitals to reduce patient readmissions or risk losing valuable reimbursement funds. CMS has now estimated that almost 2,600 hospitals across the country will be affected in the 2017 fiscal year.
Hospitals stand to lose more than 1.3 billion dollars in reimbursements in 2017. Low HCAHPS scores already cost hospitals over 850 million dollars per year in reimbursements, and the CMS readmissions reduction program also withholds over $500 million in payments due to readmissions.
Thankfully, many patient readmissions are preventable. Here are several things hospitals can do to reduce their readmission numbers.
By studying data trends, hospitals can form a persona based on the demographics that make up the majority of their readmissions. A 2011 study showed that patients on Medicaid are far more susceptible to readmissions. Among non-maternal adults ages 45-64 years old, Medicaid patients were 60 percent more likely to be readmitted than uninsured patients and about twice as likely as privately insured patients. The maternal readmission rates were 50% higher for Medicaid and uninsured patients than for those on private insurance plans.
The study also found that younger Medicare patients and patients with limited English proficiency were also more likely to be susceptible to readmissions.
According to a UCSF study, some of the most major causes of hospital readmissions are:
Emergency rooms admitting patients who didn't need to be hospitalized
Discharging patients too soon
Patients not knowing who to contact for questions or if problems arise
Patients being discharged without understanding the goals of their care
Doctors not scheduling follow-up appointments
Many of these common causes can be mitigated with more efficient and thorough communication with patients, who often don't fully understand the goals and progress of their care. Up to 25% of readmissions have been attributed to poor communication. Hospitals can significantly cut their readmission rates by taking the time to ensure that patients understand everything before they leave.
Even if doctors and nurses communicate their instructions clearly, the information has a chance of not staying with patients. Some people listen well, while others need a visual aid. Some patients need both visual and auditory cues to properly retain information. Using simple but effective communication tools (such as patient whiteboards), hospital staff can ensure that patients understand:
Their discharge dates, goals and reasons for being sent home
Follow-up appointment information
Who they can contact should they have any questions
It even helps to print out as much information as possible and send it home with patients.
When patients understand their care and discharge information, they are far less likely to be readmitted. To discover more about the benefits of patient room boards, download our free catalog.