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View All ProductsFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
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View All ProductsIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
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View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
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View All ProductsMitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.
Learn MoreUnderstanding the Readmission Definition
The readmission definition, according to CMS, applies to someone who has been readmitted to the same or another acute care facility within 30 days of an initial hospital stay. Today in the U.S. today, one in five elderly patients is readmitted to the hospital within 30 days of discharge, costing Medicare some $15 billion per year (Kowalski, 2015). However, readmission rates vary greatly by hospital and by state, providing us with an indication that we might have the opportunity to reduce rates by improving hospital processes. Hospital readmission costs are significant. As required under the Affordable Care Act, CMS began imposing a penalty on hospitals with excessive Medicare readmissions in FY2013 (October 1, 2012) as part of the Hospital Readmissions Reduction Program (HRRP). There are a number of known factors such as socio-demographic status and healthcare history that place someone at high-risk for a hospital readmission. As might be expected, frail, elderly, and lower income patients who lack support at home are at highest risk. The American Hospital Association recently conducted an analysis looking at how HRRP penalties varied by hospitals’ Disproportionate Patient Percentage (DPP). They concluded that hospitals with a high percentage of needy patients were not only much more likely to be penalized but also more likely to pay a higher penalty.
The Impact of Reducing Readmissions on Staff
The campaign to reduce hospital readmissions has changed how many healthcare organizations are looking at staffing, especially when it comes to the ratio of nurses to patients. According to an article in Healthcare Business & Technology, a study by the University of Pennsylvania found that “hospitals that staff for manageable nurse workloads have lower readmission rates. The study matched 2,826 hospitals based on the number of hospital beds. The study compared HRRP penalties between the 1,413 well-staffed hospitals and the 1,413 similar hospitals with lower staffing levels. The study concluded that closely matched hospitals based on the same patient population characteristics, still differ in HRRP penalties due to the level of registered nurse staffing. The 1,413 hospitals with low nurse staffing were significantly more likely to receive an HRRP penalty compared to the 1,413 well-staffed hospitals” (Healthcare Business & Technology, 2018).
The Impact of Reducing Readmissions on Revenue
Readmissions are expensive for CMS and for the hospitals where they occur. For example, “Hospital readmissions cost Medicare about $26 billion annually, with about $17 billion spent on avoidable hospital trips after discharge, according to data from the Center for Health Information and Analysis” (Lapointe, 2018). When the impacts are measured for hospitals, hospital readmission costs are dramatic, even as the program realizes some measure of success. According to one article, “Decreasing hospital readmission rates through the program came at a price for some hospitals. CMS penalized over 2,500 hospitals by more than $564 million in 2017 for excessive 30-day hospital readmission rates. And Medicare isn’t the only payer pressuring providers to prevent hospital readmissions. Readmissions of privately insured and Medicaid beneficiaries cost $8.1 billion and $7.6 billion, respectively, AHRQ found” (Lapointe, 2018).
The Impact of Reducing Hospital Readmissions on Care Quality
Fierce Healthcare cites a 2017 study published in the New England Journal of Medicine that looked at the connection between high-quality care and lower readmission rates. Researchers found that “Hospitals in the highest performance quartile for quality had significantly lower 30-day readmission rates than those in the lowest quartile. The lowest performers had a readmission rate of about 25%, while the highest performers had a readmission rate of about 23%” (Minemyer, 2017). While 2% may not seem like much, researchers offered “that for every 50 patients who are admitted to a hospital in the lowest-performing quartile rather than in the highest-performing quartile, there is one additional readmission” (Minemyer, 2017).
Key Steps to Take to Reduce Readmissions
A previous HealthStream blog post discussed multiple steps hospitals should be taking to prevent and reduce hospital readmissions:
Focus on plans for discharge as soon as the patient is admitted. You can’t wait until the day before. You need to try to have everything in place before the patient leaves the hospital.
There also needs to be good communication all around. Physicians, nurses, case managers, social workers, therapists, family members, and the patient all need to work together during the patient stay to address all of the patient’s post-discharge needs.
Contact the pharmacy department to make sure they can support any unusual medications that the patient might need upon discharge.
Ensure that there is prompt discharge follow-up with the primary care physician and other post-acute organizations that might be involved. We know there is a strong relationship with how soon the patient sees their primary care physician and hospital readmission rates.
Additional measures that may prove beneficial in reducing hospital readmissions are:
Identifying the Root Cause of a Readmission, then using data analysis to determine which patients are most at risk, due to social determinants of health or their specific health conditions.
Optimizing care transitions to prevent communication breakdowns that can occur during discharge planning and early recovery.
Improving patient engagement and education so that patients and families understand their responsibilities and role in the recovery process. (Lapointe, 2018)
References
Healthcare Business & Technology, “Low nurse staffing may cost your facility millions of dollars,” January 2, 2018, Retrieved at http://www.healthcarebusinesstech.com/low-nurse-staffing-may-cost-your-facility-millions-of-dollars/.
Kowalski, Cyndy. “Readmission Reduction: A look at strategies for lowering hospital readmissions across the continuum of care,” Besler Consulting, www.besler.com, p. 5, January 2015.
Lapointe, Jacqueline, “3 Strategies to Reduce Hospital Readmission Rates, Costs,” Rev Cycle Intelligence, January 8, 2018, Retrieved at https://revcycleintelligence.com/news/3-strategies-to-reduce-hospital-readmission-rates-costs.
Minemyer, Paige, “Data shows link between hospital quality and readmission rates,” Fierce Healthcare, September 14, 2017, Retrieved at https://www.fiercehealthcare.com/finance/hospital-quality-impacts-readmission-rates-study-finds.
Learn more about HealthStream solutions that target readmissions.
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ResuscitationIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsHealthStream's EMS Program offers a comprehensive, CAPCE accredited EMS course library that meets National Registry annual recertification.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsLearn more about HealthStream's Provider Credentialing, privileging, & enrollment solutions.
View All CredentialingExperience standardized and centralized healthcare credentialing, privileging, and enrollment that is smarter and faster than ever before.
View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
View All ProductsNCQA-certified CVO verification services for initial and re-credentialing files in an overflow or full-service capacity for healthcare organizations.
View All ProductsSearch, review, and add providers into the Epic provider master file with our Epic app integration, Provider Validate.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All Scheduling & Capacity ManagementHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All Products