Portland, OR (PRWEB) October 08, 2013
Under the HRRP, effective for discharges beginning on or after October 1, 2012, Medicare will penalize hospitals for higher-than-expected rates of readmissions. The CMS hospital quality-of-care measures include hospital 30-day risk-standardized readmission measures for acute myocardial infarction, heart failure, and pneumonia—common conditions with substantial mortality and morbidity, imposing a substantial burden on patients and the healthcare system.
During a recent webinar hosted by AllMed Healthcare Management, Dr. Michael Firstenberg, a board-certified cardiothoracic surgeon, discussed measures that hospitals can take to reduce cardiology readmissions. Since the Centers for Medicare & Medicaid Services (CMS) enacted the Hospital Readmissions Reduction Program (HRRP) in 2012, hospitals continue to face the challenge of bringing down their readmission rates. According to Dr. Mueller, studies have shown that as many as 20% of patients are readmitted within 30 days of hospital discharge, resulting in billions of dollars in excess billing.
Dr. Firstenberg described numerous drivers for cardiology readmissions, including both hospital- and patient-related factors. While some patient-related factors that affect readmission cannot be modified (e.g., age, sex), Dr. Firstenberg noted that identifying high-risk patients using risk prediction models and calculators developed for specific procedures can help clinicians target individuals for prevention. Hospitals must examine and improve their processes related to communication, discharge planning and follow-up, medication reconciliation, and patient education. In addition, studies that have shown that administering prophylactic preoperative antibiotics significantly reduces infectious complications in patients undergoing cardiac surgery.
The traditional approach to assessing efficacy and safety of care has focused on looking at length of stay, complications arising from surgery, unplanned reoperations and readmissions, and mortality. Although examining these criteria remains crucial, Dr. Firstenberg stressed that additional measures are needed in order for hospitals to establish effective best practices for reducing readmissions.
Hospitals must identify trends and patterns in indications for readmission, examine how quickly patients were seen after their procedure, and determine when cardiac rehabilitation was initiated. Ongoing evaluation of physicians can facilitate this process, uncovering not only problematic practice patterns, but also physician- and hospital-level issues that need to be addressed. Readmissions, which can be costly and potentially harmful, are often avoidable. Identifying and reducing avoidable readmissions can improve patient safety, enhance quality of care, and lower healthcare spending.
AllMed Healthcare Management provides external peer review solutions to leading hospital groups and ASCs nationwide. AllMed offers MedEval (sm) and MedScore(sm), which help facilities improve physician performance through both periodic and ongoing case reviews at the individual or departmental levels. Services are deployed through PeerPoint®, AllMed’s state-of-the-art medical review portal. For more information on how AllMed can help your organization improve the quality and integrity of healthcare, contact us today at info(at)allmedmd(dot)com, or visit us at http://www.allmedmd.com.