The Well-Being Journal

New Study Demonstrates Impact of Care Transitions in Preventing Hospital Readmissions

Cameron Bowman

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.

For more information on the Healthways Care Transitions Solution, view our webinar or download our fact sheet.

To read the full study, click here.

Topics: Healthcare Trends in Healthcare Science and Research Care Transitions Solution

Five Game Changing Trends in Healthcare

Jennifer Rudloff

While we can’t predict the future, we think that it’s always important to keep a watchful eye out for trends in our industry. The field of healthcare is one that constantly evolves, as new implications constantly arise for doctors, patients, and well-being support providers like us.

Below is a list of several major emerging trends in healthcare that we think could be truly ground breaking. In our opinion, these trends – for which we’ve begun to see the seedlings – could be total game-changers, for Healthways and for the industry at large.

Here are five patterns in the healthcare industry that we think have the potential to stick around, at least for the time being:

  1. Health plan preparation for state insurance exchange implementation, which is projected to cause significant disruption of individual and small group fully insured businesses;
  2. Change from a volume-based to a value-based payment system, a change which comes with the associated shift of financial responsibility (and thus, risk) for cost and quality from health plans to providers;
  3. Increasing payer requests for comprehensive, integrated solutions, as more insurance clients aim to address longitudinal health risks and care needs for total populations;
  4. Adoption of population health management on a global scale, by both foreign government and foreign private sector health organizations; and
  5. Recognition by large employers of the expanded value of improved well-being, to reduce medical cost and improve individual and company productivity and performance.

This is just the beginning of changes we expect to see in the industry; momentum has already begun to pick up, and we’re excited to see how the space evolves. Particularly due to the upcoming 2012 presidential elections, our healthcare industry may be in its most malleable state ever – and this may hold direct or indirect impact upon our well-being as a country.

So, what do you think? How have you witnessed these industry trends in your own healthcare experiences? What are some other major changes in healthcare that you see on the horizon? Let us know by leaving comments below or on our Facebook page!

Topics: Healthcare Health Healthways Trends in Healthcare Health Plan & Health System