To circumvent the $17 billion in preventable readmissions costs paid by Medicare each year, financial incentives imposed by the Hospital Readmissions Reduction Program (HRRP) now penalize hospital and healthcare providers for unnecessary or excessive readmissions for several common diagnoses. These conditions include heart failure, pneumonia, heart attack, COPD, elective hip or knee replacement procedures and, beginning in October 2016, coronary artery bypass grafting.
In the past year, over 2,500 hospitals nationwide received penalties amounting to $420 million because they did not meet HRRP requirements, and of those, 38 hospitals accrued the maximum possible penalty. In order to avoid punitive measures, healthcare providers are increasingly concerned with improving overall quality of care and reducing the rate of preventable hospital readmissions. A recent study published in the American Journal of Managed Care highlights the effectiveness of one solution aimed at lowering preventable readmissions through a comprehensive, patient-centric approach.
The Healthways Care Transitions Solution® demonstrated impressive results in real world analysis, reducing 30-day readmission risk by 25% overall and the odds of any readmission within six months by over half among program participants with readmission penalty conditions, including heart failure, heart attack, chronic obstructive pulmonary disease and/or pneumonia. By addressing the underlying causes of preventable readmissions, rather than just managing the primary diagnosis, the program improved the overall health of patients and allowed hospitals to efficiently implement an effective approach to reduce the number of preventable hospital readmissions.
Through the use of science-based predictive modeling, the program is able to selectively deliver care to those patients at the highest risk of readmission prior to discharge. Additionally, trained clinicians complete follow-up interventions with patients telephonically to prevent readmissions post-discharge. The Healthways Care Transitions Solution represents the type of innovation that is increasingly in demand by health systems, physicians and patients.
Earning the exclusive endorsement of the American Hospital Association, the acute and post-acute care transitions management solutions provided by Healthways succeed not only in effectively navigating the shift from fee-for-service to value-based care, but also supports the interdisciplinary management of patients across the continuum of care.
To read the full study, click here.