Hospitals Get Early Start on Medicare Reform Sector

August 23, 2017
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Ripple effect of reform? Perhaps, but in light of the federal government’s push to eliminate waste in Medicare, one arena in which costs are paid out in massive amounts — hospital admissions — aims to do its part.  A couple of years from now, it will be mandatory for penalties to be applied to hospitals with an unacceptable level of readmission rates among their Medicare patients. Defined as readmissions within 30 days (for such common conditions as pneumonia and heart failure), these cases average out to about $7000 a pop (or more than $11B annually). Of course, it’s all about transparency, and healthcare consumers can get their eyeful of comparators at a site set up by HHS here.

A growing number of hospitals and health systems are already working on the readmissions problem with support from nonprofit groups and foundations. Piedmont Hospital in Atlanta is one. A few years ago, it began participating in Project Boost, a discharge-transition program developed by the Society of Hospital Medicine. Through Boost, Piedmont proactively targets patients who are at high-risk of readmission. Staff members use a checklist to ensure that potential logistical and psychosocial problems are addressed before the patient leaves the hospital. Another priority: scheduling patients before discharge for their first follow-up visit to the doctor.

Meat-and-potato moves by hospitals also include specialized discharge “coaches”, whose job it is to make sure all loose ends surrounding a patient’s discharge — such as medication administration, following doctor’s discharge plans, and other preventable factors on the patient end keep the patient out of the hospital. All of this is a good start — but only a start; in such a discrete, but fiscally important care arena among Medicare services, it’s important for lawmakers, healthcare policy thinkers, and administrators to focus on federally generated care delivery in all care arenas (not the least of which is the Medicaid-heavily financed LTC sector).