Preventing Those 20-30-Day Re-Admissions or ER Visits is Easier than You Think

The cost of readmissions of clients to hospitals or ERs after discharge is substantial. Medicare is spending approximately $17.4 billion annually for people who return to the hospital or ER for the same reason they went in. The Hospital Readmissions Reduction Program (HRRP), established in the Affordable Care Act, authorizes Medicare to reduce payments to hospitals with excess readmission rates. The penalties are based on Medicare beneficiaries hospitalized with heart failure, pneumonia, acute myocardial infarction, and other preventable disorders and conditions.

How does this affect the home health and homecare industry? Since hospitals are penalized for re-admissions, the pressure is on the agencies to help the clients stop returning to the hospital or ER and provide non-emergency/acute care at home.

Whether you are a home health or home care agency, both types of agencies are crucial in preventing your clients from being re-admitted to the hospital or ER.

 Home Health Nurses must be trained in doing a better comprehensive assessment of their clients and to have the awareness of who could be potential clients that may be admitted back to the hospital or ER. Homecare agencies may not have the skills or knowledge of a nurse, but they still can help prevent issues by training their staff on what to look for if they think their client may need medical care before an urgent situation, and when to call the client’s physician.

It is just a matter of time before CMS starts to penalize home health agencies for patient readmissions. Can you afford the penalty? What about the loss of income that will occur because the client(s) are hospitalized?

So, what should you do? Make sure your nurses have an effective care coordination plan, and if you are a home care provider instruct your staff to be alert to changes in your client’s condition so the client’s physician can be notified.

To Your Success during the rest of 2024! 

Sharron