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Providers that help patients manage chronic conditions face fewer readmission penalties, study finds

Preventable hospital readmissions are estimated to account for more than $17 billion in Medicare expenditures each year; hospitals pay as a result.

Jeff Lagasse, Associate Editor

Taking a more proactive role in helping patients manage their chronic conditions keeps them more engaged in the process of their care, which can save hospitals money in the form of avoided readmission penalties, according to a new study by communications firm West.

The savings are well worth the investment. Preventable hospital readmissions are estimated to account for more than $17 billion in Medicare expenditures each year, and some of those Medicare costs are passed on to hospitals in the form of those pesky penalties -- projected to cost about $528 million during the 2017 fiscal year. Under the Hospital Readmission Reduction Program, about half of all U.S. hospitals were hit with payment penalties last year.

Effectively managing chronic diseases also leads to better outcomes, which in turn leads to a higher public opinion, impacting how much a provider can earn consumer confidence and attract revenue, the study found.

[Also: ACO-affiliated hospitals see fewer readmissions from skilled nursing facilities, study finds]

A survey conducted by West reflects a knowledge gap among patients when it comes to managing their chronic diseases. About 39 percent of respondents admitted they were only somewhat knowledgeable, at best, about how to effectively manage their condition.

A patient who has never had diabetes, for example, is not likely to know how to take a blood glucose reading, or what that reading even means. They may not know how to follow a healthy diet, or what symptoms might signal the need for immediate medical attention. That knowledge gap isn't typically something they can overcome on their own, the study said.

A big part of the problem, said West, is that many patients don't have a good grasp of health metrics, They may know they're unhealthy, but they don't understand where there metrics fall on the spectrum of healthy to unhealthy. Most providers -- 75 percent, in fact -- feel only somewhat confident that their patients are truly informed about the state of their health.

Getting patients to understand those metrics is essential for reducing the complications of their conditions. That means they need better disease management support from providers.

A key strategy in that regard is extending chronic disease management to the home. At least 70 percent of patients with a chronic condition said they'd like more resources or clarity on how to manage their disease, and 91 percent said they need help doing so. The support that patients are now getting from providers occurs mostly in a physician's office -- which are important, but may not be meeting patients' needs fully.

[Also: Hospital nutrition programs may shorten patient stays, reduce readmissions by as much as 27 percent]

Overall, 39 percent of patients indicate that they are likely to need help managing their condition between appointments. Meanwhile, two in three patients say the information they receive from their provider about managing their condition is general, and not specific to their case.

The study suggests that tailoring communications is an effective strategy for helping patients manage their chronic ailments. Providers can tailor chronic care information by using information from health records. They can also personalize all of their communication and reminders, and use email, voice and text messaging to connect with patients through their preferred form of communication, and at their preferred times.

Surveying patients is another effective chronic care strategy, according to West. Automated surveys allow providers to monitor patients in their home environment and intervene before they need acute care.

Biometric monitoring devices are yet another option for providers. Heart rate monitors, blood pressure cuffs, pulse oximeters, blood glucose meters and other devices can be used to collect health readings remotely.

Those strategies can improve outcomes, the study said. And when patient outcomes improve, unnecessary hospital readmissions decrease, patients have better overall experiences, and hospitals and health systems can earn more reimbursements and avoid penalties.

Twitter: @JELagasse

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