3 Strategies to Reduce Your Hospital Readmissions Penalties

Sep 18, 2024Data Management

The Hospital Readmissions Reduction Program (HRRP) was created in 2010 by the Affordable Care Act in effort to make hospitals pay more attention to patients after they leave their facility. Prior to the beginning of this program in 2008, nearly a quarter of Medicare heart failure patients ended up back in the hospital within 30 days. HHRP wanted to encourage hospitals to improve their communication and care coordination to better engage patients and caregivers in discharge plans and, therefore, reduce avoidable readmissions by linking payment to the quality of hospital care.

Payments, or penalties, are calculated by tracking three years of Medicare patients. Once CMS sends hospitals their annual confidential Hospital-Specific Result (HSR), they are given 30 days to review and submit questions or recalculate corrections before payment is issued. These payments are often hundreds of thousands (if not millions) of dollars and can be a big hit to a hospital’s tight budget.

So how can your hospital reduce these costly penalties by reducing CMS patient readmissions overall?

 

Keep tabs on patient conditions

When patients get discharged from your hospital, it is often nearly impossible for hospital physicians to remain looped into their care and how their treatment plans are going until it’s too late, and they end up readmitted back into an acute care setting. Utilizing tools with clinical insight into patients’ conditions while they’re still in a skilled nursing facility (SNF) or rehabilitation center can mean the difference between thousands of dollars (if not more) in readmissions costs as treatment plans can be tweaked in nearly-real time to better improve the discharged patient’s outcome.

 

Monitor critical medications & vitals

The ability to supervise a patient’s medications and vitals in a post-acute setting can make all the difference in whether or not they end up back in the hospital. Being able to receive seamless access to data on their conditions enables care teams to prescribe medications such as antibiotics to ward off possibly dangerous infections as well as to reduce facility-acquired conditions. Real-time access to vital information means physicians can act quickly before patients’ conditions worsen to the point where they need to be readmitted into an acute care facility and can provide treatment while they remain in the SNF or rehabilitation setting.

 

Utilize predictive modeling to ensure recovery is on-track

Assessing condition data through predictive modeling tools can help care teams determine if recovery and care rates meet predetermined clinical expectations. Utilizing a tool that provides information on matching a patient’s discharge condition with the right care facility through at-a-glance dashboards can vastly improve outcomes and ensure that patients are recovering as to be expected based on what is typical of their state.

It’s a well-known fact that providers oftentimes have limited, if any, clinical line-of-sight into a patient’s condition once discharged, but that doesn’t need to be the case! DataBank’s hospital readmissions solution equips providers with real-time insight to high acuity discharged patients where they will receive seamless access to information about their vitals, medications, lab reports, and more at the discharged facility.

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