The Challenge of Preventing Readmissions

The readmission rate at WMHS has dropped over 20% from about five years ago to around 10% today.  Reducing readmissions is critical since we are not paid for those re-admissions within 30 days if the readmission is related to the same co-morbidities or disease classifications.  A recent article in the Wall Street Journal calls into question as to just how much control hospitals have in controlling readmissions.  The article states that it is a worthy goal, but can jeopardize the health of the patient and the bottom line of the hospital.  I am not concerned about the bottom line since WMHS is paid on a value basis, but we are always on guard to ensure that if the patient requires readmission that they are re-admitted.  We don't withhold care because of a penalty; we try to learn from the reasons as to why the patient had to be re-admitted.  There are many reasons for readmissions and some can't be prevented, but hospitals can play a role in preventing them.  One factor was discharging patients too soon.  We perform a chart review on every readmitted patient as well as interview the patient and / or family members to ascertain why the readmission occurred.  We have found that there is less that we can do for the non-compliant patient as well as the poor and the elderly with little to no family support.  The social factors contribute greatly to readmissions and as a safety net provider, in this case, we carry a greater burden due to the lower socioeconomic status of our population.  Our philosophy has been that we need to control the readmissions that we can and work with the non-compliant, the poor and the elderly in other ways to hopefully prevent readmissions in the future.