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Health Works Collective > Business > Hospital Administration > Person-Centered HealthCare: Can Patient-Centered Care Reduce Hospital Readmissions?
BusinessHospital AdministrationPolicy & Law

Person-Centered HealthCare: Can Patient-Centered Care Reduce Hospital Readmissions?

David Harlow
Last updated: December 14, 2012 7:25 am
David Harlow
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Photo:Hospital/shutterstock

A new Press Ganey white paper highlights an association between HCAHPS performance — patient experience scores — and lower rates of readmission. (Performance Insights – The Relationship Between HCAHPS Performance and Readmission Penalties.)

With Medicare payment penalties for excess readmissions now in effect, reducing readmissions has become a top priority for hospitals and other stakeholders. The Centers for Medicare and Medicaid Services (CMS) publicly reports risk-adjusted readmission rates for heart attack, heart failure and pneumonia. The data show significant variation in performance across hospitals, indicating that some hospitals are more successful than others at addressing the causes of readmissions. A new study by Press Ganey suggests that performance on readmission metrics is associated with performance on patient experience of care measures.

This study is an interesting look at the relationship between two value-based purchasing programs used by CMS to calculate Medicare payments to hospitals — the Hospital Value-Based Purchasing Program and the Readmissions Reduction Program.

The key learning from this study is this:  

Effective communications is fundamental to ensuring that patients become engaged in their care and, consequently, better equipped to follow discharge instructions and self-monitor after leaving the acute care setting.

Coupled with patient-centered practices supported by past studies which have shown that “the single most effective strategy for improving patient satisfaction is purposeful hourly rounding by nursing staff,” a “sustainable discharge” strategy is highlighted as a key predictor of avoided readmissions.

A sustainable discharge strategy comprises identifying and addressing patient-specific factors that could lead to readmission, strategic patient education, developing a patient-focused after-care plan and ensuring a smooth transition to a post-acute setting. Tactics that drive success in achieving sustainable discharges include: dedicated patient transition coaches, proactive planning for non-medical barrier to treatment adherence, post-discharge phone calls, scheduled follow-up care, and use of cross-setting discharge planning tools and teams.

In other words, a patient-centered discharge planning process, built on clear communications with the patient, is likely to reduce readmissions.

With more than 20% of Medicare beneficiaries discharged from an acute care hospital being readmitted within 30 days, at a cost of over $15 billion a year, and with over 2000 hospitals looking at readmissions reduction program Medicare payment penalties in FFY 2013 totaling $280 million, this is a significant issue — but one where a potential solution is clearly at hand.

If you like this post, please read other posts in the series on the Person-Centered HealthCare main page. And if you have a story to tell that may be a fit with our series, please comment below or email me at joan@socialmediatoday.com

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By David Harlow
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DAVID HARLOW is Principal of The Harlow Group LLC, a health care law and consulting firm based in the Hub of the Universe, Boston, MA. His thirty years’ experience in the public and private sectors affords him a unique perspective on legal, policy and business issues facing the health care community. David is adept at assisting clients in developing new paradigms for their business organizations, relationships and processes so as to maximize the realization of organizational goals in a highly regulated environment, in realms ranging from health data privacy and security to digital health strategy to physician-hospital relationships to the avoidance of fraud and abuse. He's been called "an expert on HIPAA and other health-related law issues [who] knows more than virtually anyone on those topics.” (Forbes.com.) His award-winning blog, HealthBlawg, is highly regarded in both the legal and health policy blogging worlds. David is a charter member of the external Advisory Board of the Mayo Clinic Social Media Network and has served as the Public Policy Chair of the Society for Participatory Medicine, on the Health Law Section Council of the Massachusetts Bar Association and on the Advisory Board of FierceHealthIT. He speaks regularly before health care and legal industry groups on business, policy and legal matters. You should follow him on Twitter.

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