Patient education cited as a key factor
Ephrata Community Hospital (ECH) is one of 46 hospitals in Pennsylvania that was not penalized in fiscal year 2014 as part of a Medicare program to reduce the number of patients readmitted to hospitals within 30 days of discharge.
The federal Centers for Medicare and Medicaid Services (CMS) penalized 71 percent of Pennsylvania hospitals an average of less than 1 percent of their Medicare reimbursement for having elevated readmission rates this year.
The penalties are based on readmissions of Medicare patients, who were originally admitted with at least one of three conditions—heart attack, heart failure and pneumonia.
The penalty program is among the toughest of the federal government's efforts to pay hospitals for the quality of their performance rather than the number of patients they treat.
Susan Shollenberger, assistant vice president, quality and compliance, Ephrata Community Hospital, said: “We are pleased with our success in lowering readmission rates. It’s reflective of a lot of hard work and persistence.”
Shollenberger cited patient education as a key factor.
“It’s important to start patient education as close to admission as possible,” she stressed. “You can’t save the bulk of it for the last day.”
She added that it’s helpful to have a patient’s caregiver present for the education, if possible. Patients need to understand their medications and transition instructions when they leave the hospital.
“We also follow up with patients to make sure they have a visit scheduled with their primary care physician within five to seven days of leaving the hospital,” said Shollenberger.
The Medicare Payment Advisory Commission (MPAC), which reports to Congress, has estimated that 12 percent of Medicare patients may be readmitted for potentially avoidable reasons. Averting one out of every 10 of those readmissions could save Medicare $1 billion, according to MPAC.
Medicare will launch the third phase of the program on Oct. 1, 2014, when it will raise the maximum penalty to 3 percent, and expand the number of conditions for which readmissions are penalized to include chronic lung disease and elective hip and knee replacements.