"The Ronan Report" provides insight about the activities at the Western Maryland Health System in Cumberland, Maryland, and about the changes taking place in healthcare today from a CEO's perspective.

Wednesday, July 31, 2013

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.

1 comment:

  1. Mr Ronan
    sometimes, the patient feels that they shouldn't be discharged, but the MD or RN doesn't seem to want to hear that. Maybe the patient is scared, but the MD seems to just want to discharge them so they can have the room for another patient. "You'll be fine. Are there any other questions?" I guess if you've never been thru it, it's hard to see.
    Thank you
    Look forward to reading your blog every day.