Per Annals of Internal Medicine findings from a retrospective population-based analysis, Medicare Advantage users, had higher risk-adjusted 30-day hospital readmission rates compared to traditional Medicare beneficiaries. Hospital admissions were compared for three common medical conditions.
Hospital readmissions are one of the significant reasons behind the decline in healthcare organization’s revenue. No hospital wants their patient to be admitted again and again.
So, what is hospital readmission?
When due to various reasons, personal or in the healthcare front, a patient get readmitted in the hospital shortly(or not) after they have been treated for the same, it is hospital readmission which puts facility under financial strain.
- The higher the readmission rate, the higher would be the probability to get penalized by the Affordable Care Act.
- This determines the quality of treatment and care provided by the hospital, which puts their reputation at stake.
- The patient’s condition might get severe and reach the stage where it can no longer be treated, which will again question your hospital’s treatment and medications.
So, what leads to the patient coming back to the hospital with dissatisfaction or their health condition becoming worse than how they were discharged?
- LANGUAGE BARRIERS:
Not every patient that comes looking for treatment has English as their native language. This is why most of them are unable to understand their condition that they should and the aftercare instructions, which brings them back to the hospital.
Aside from the language, technology is also a significant barrier, which makes it difficult for the patient to follow what has been prescribed. A patient does not understand half of the treatment whose foundation is modern technology or how technology can help improve their recovering, which leads to slow improvement and readmissions
- HEALTHCARE INSURANCE:
What type of health insurance is the patient covered under, decides the number of readmission rates? Compared to government health insurance, those covered under private health insurance have lesser readmission, and the practices are less prone to be penalized under the Affordable Care Act.
- HEALTH EDUCATION
Patient’s limited knowledge of their condition and the medical treatment can stop them from asking questions, seek advice, and know more about how to take better care of themselves. This will increase their admission to the hospital. Not educating the audience or providing them with information related to their medical condition is only going to take a toll on the facility’s financial health.
- SOCIAL FACTOR:
A patient needs strong social support from their family, hospital, and caregivers to make the shift from discharge to aftercare in their home. This time is extremely critical as it can either increase or reduce the readmission rate. If the patient is not getting adequate social support (which many healthcare practices fail at), the hospital readmission will increase.
Low-income areas that do not have the accessibility to modern technology have a high readmission rate compared to the higher income areas. With their minimum to zero risk assessment and management policies, they are also more prone to penalties, adding to the financial burden and damaging the reputation.
Now that you know what is leading to hospital readmissions and how it is adversely impacting your healthcare’s revenue cycle, allow us to help you with specific tips that can help cut down your hospital readmission:
- IDENTIFY THE ROOT CAUSE:
Of the causes mentioned above, check which challenge is your healthcare practice facing that is leading to the escalation of hospital readmission rates. Depending on that strategize an active policy to curb it or improve it. Modern technology, such as data analysis can help identify the patient that has the maximum readmission risk. Moreover, social determinants can help better filter out the causes and develop a more tailored approach for preventing hospital readmission.
- PROMPT FOLLOW UP:
One of the most effective ways of reducing readmission rates is a rapid follow up within seven to ten days of hospital discharge to ensure that the patient is adequately following the medications and it is helping reduce the complication as expected. Timing of the follow up has a massive impact on the hospital readmission rates.
- ADEQUATE TRANSITION:
A critical aspect that impact the hospital readmission is the improper transition between treatment to care and home settings. It is the hospital’s responsibility to make sure that healthcare service is adequately dispensed, no matter the setting. There should be proper discharge planning and risk assessment to ensure that the transition care is well optimized and hospital readmission is prevented.
- ENHANCE PATIENT ENGAGEMENT:
Communication is one of the most significant barriers in the transition from treatment to aftercare. Transitioning need proper communication of recommendation, instruction, medical regimens between the patient, caregiver, and the physicians. It is very natural for the patient to not immediately have a grasp of how to ensure proper aftercare or have a limited understanding of the medical condition. This threatens the possibility of hospital readmission. This is why it is essential for the hospital to ensure that there is a proper program launched for active engagement and education of the patients regarding the medical condition and how they have to go about their routine after they are discharged from the hospital. This can include appointment reminders, transportation facility support, etc.
- OUTSOURCING ENTIRE FINANCIAL SYSTEM:
Hospital readmission impacts the reputation as well as the entire financial health of the practice. If you feel your in-house team is burdened under the performance pressure, why not outsource the revenue cycle management; be an aspect of it or the complete cycle? Take, for instance, the appointment reminder; a follow-up reminder after a week of treatment can identify complications in the treatment and medication beforehand and keep patient vigilant about their health. We at Medphine provide dedicated appointment reminder service to ensure that the patient no show (one of three critical setbacks to the financial health of the practice) is significantly reduced and they show up at the time, which will also have a positive impact on the hospital readmission rates.
We believe in giving our clients the freedom to the first try, and they buy our services, which is why we are offering our services on a 30-day free trial basis with no obligation to sign up a long term contract.
Our appointment reminder service will make sure that your practice’s readmission rates get reduced with immediate effect.