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Incentives change readmissions equation

But much work still needs to be done in the transition to value models

Hospitals are increasingly making reducing hospital-acquired infections and readmissions a priority – and saving millions of dollars in the process – but there are still infrastructure gaps.

For example, Dignity Health, one of the five largest hospital systems in the nation, saved an estimated $30 million in two years through evidence-based practices and a training regimen for nurses, called MeasureVentionists, which focused on preventing hospital-acquired infections and readmissions.

For the third consecutive year, the Department of Health and Human Services named Dignity Health as one if its Partnership for Patients Hospital Engagement Networks. The $218 million Partnership for Patients initiative, currently totaling 3,700 hospitals, was launched in 2011 to help identify and spread ideas to improve patient care and reduce hospital-acquired infections.

 “We have committed efforts across our hospitals to evaluate strategies that result in reducing unnecessary readmissions, especially within a short time after discharge,” said Barbara Pelletreau, vice president of patient safety at Dignity Health.

Pelletreau said one of the specific takeaways from the two-year program is the importance of including both patients and family members in discharge instructions, such as why medications have been prescribed, how to appropriately use them, and whether there are any potential side effects.

“To reduce readmissions on a broad or system-wide level, it is critical to have a clear set of coordinated strategies in place across teams, departments and hospitals,” Pelletreau said. “Strategies should include measures that take into consideration the many physical, social and psychological factors that affect a patient’s risk for readmission and implement best practices to address them.”

While most of the healthcare system hasn’t transitioned to the value model yet and is still primarily fee-for-service, change is afoot because incentives are finally in place for hospitals to focus on preventing readmissions, remarked Chuck Peck, MD, managing director at Navigant. “It was always better for the patient not to be readmitted, but the incentive just wasn't there,” he said.

There is still work to be done, though, he said, to fill gaps not currently covered by value models and without such structures, “… it's going to be really hard to get people to change their behavior.”



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