Healthcare News & Insights

Readmissions penalties set to increase soon: 1 thing hospitals can try to avoid fines

Time’s ticking for hospitals with high readmission rates – Medicare’s upping the ante, increasing the penalties these hospitals will receive on Oct. 1.

161824863In all, the Centers for Medicare & Medicaid Services (CMS) has identified over 2,000 hospitals in almost every state that are slated to receive cuts to their reimbursement this fall. This amounts to two-thirds of eligible hospitals in the Medicare program.

But there’s a bit of good news in this, as well. Many hospitals will actually experience a smaller decrease in their payments than they did last year. In fact, according to an article in Kaiser Health News, the total dollar amount for the fines will be $53 million less than last year’s fines. Over 1,300 hospitals are slated to pay smaller fines.

However, 18 hospitals didn’t fare so well – they’ll be paying the highest penalty this year, with 2% drops in their payments. Penalties are increasing for 1,074 other hospitals, and 283 new hospitals that weren’t fined this past year will be subject to fines this year.

So it’s a mixed bag for hospitals this year.

A different way of following up

Keeping readmissions rates under control can be a tall order at times. With steeper cuts in reimbursement rates looming as time passes, what can hospitals do to improve their chances of avoiding penalties?

Time and time again, it’s been proven that proper follow-up care after discharge leads to a decrease in readmission rates. A recent study reiterates the importance of fully following up with patients.

And the key to better follow-ups could be as simple as a phone call.

The study, published in JAMA Surgery, looked at patients who were discharged from the hospital after having open hernia repair surgery or a laparoscopic cholecytectomy. It found that those who followed up via telephone had the same rate of complications as those who physically went to a doctor’s office for their follow-up appointment – and the rates were very low for both surgeries.

According to an article in American Medical News, most of the patients who received follow-up phone calls specifically asked for phone calls instead of personal visits, and they reported high levels of satisfaction with their care.

For the phone follow-ups, physician’s assistants asked patients questions over the phone to indicate how their recovery was going. If any adverse affects were reported, patients were given advice on how to manage them, with visiting the doctor or hospital suggested only if their conditions indicated something serious, such as an infection.

Scheduling a follow-up phone call with a patient at discharge may be very effective in improving patient outcomes. Depending on the results of the phone call, patients could receive additional care or instructions before their condition worsened enough to require another hospital stay.

While in-person follow-up visits scheduled with a patient’s primary care physician were also effective, phone calls were more convenient for patients. They didn’t have to take time out of their day to travel to a doctor’s office or hospital, which made it easier for them to keep their appointments – and for providers to keep tabs on their conditions.

Phone calls can also be more time-effective for providers, allowing them to more quickly and efficiently evaluate whether patients need additional care upon their release from the hospital.

Adding this one extra step to your discharge process could save your hospital millions in penalties from the feds. And even if your hospital sticks to coordinating in-person follow-up visits for patients with their doctors, this can still keep your readmission rates low. It’s certainly something to think about when evaluating your discharge procedures.

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