Physicians play a vital role in continuing efforts to reduce avoidable hospital readmissions which is within a broader goal set by the Centers of Medicare and Medicaid Services (CMS) to deliver more coordinated, high quality care for patients. Many studies suggest that a key component in contributing to reducing hospital readmissions is communication, especially between physicians. Often times, a lack of communication between physicians and post-acute providers inhibits physicians from delivering quality, patient centered care, and increases the chances of avoidable hospital readmissions. A study by the American Medical Association highlights the critical role that physicians play in reducing hospital readmissions by helping their patients make safe transitions after being discharged from the hospital to either a post-acute or home care setting. In another study published by the Journal of the American Medical Association (JAMA), it was found that patients who are discharged from hospitals that have higher early follow-up rates have a lower risk of 30-day readmission. By improving communication between providers and patients, especially during discharge, physicians can reinforce positive patient behavior that can often prevent a return to the hospital.
Hospital readmission has been a longstanding concern for CMS throughout the acute and post-acute care settings. Section 3025 of The Affordable Care Act (ACA) added a section to the Social Security Act which established the Hospital Readmissions Reduction Program to address significant hospital readmission concerns. Hospitals will get fined for failure to meet the criteria of CMS’ focus on six specific conditions which include heart attacks and congestive heart failure. This program also provides strong incentives by rewarding hospitals and physicians to avoid complications, prevent hospital readmissions, and speed recovery. On September 13, 2016, The Center for Medicare and Medicaid Services (CMS) announced new data showing that 49 states effectively reduced avoidable hospital readmissions and that that the avoidable hospital readmissions program efforts are working. This data was based on hospital readmissions from 2010 to 2015 and shows readmission rates fell by 8 percent nationally. Additionally, all states but one have seen Medicare 30-day readmissions fall. In 43 states, readmission rates fell by more than 5 percent; and in 11 states, readmission rates fell by more than 10 percent. Furthermore, the data estimates that 565,000 Medicare beneficiaries have avoided hospital readmissions. This new data further incentivizes physicians to comply with Medicare requirements to strengthen existing processes and propose new ideas that will help providers continue to reduce hospital readmissions. Physicians hold the key to engaging other providers and patients at each point along the care continuum in efforts to improve communication, coordination, and discharge planning.
Sources:
1. 1. https://blog.cms.gov/2016/09/13/new-data-49-states-plus-dc-reduce-avoidable-hospital-readmissions/
2. Hernandez AF, Greiner MA, Fonarow GC, et al. Relationship Between Early Physician Follow-up and 30-Day Readmission Among Medicare Beneficiaries Hospitalized for Heart Failure. JAMA. 2010;303(17):1716-1722. doi:10.1001/jama.2010.533.
Compliagent
