The CMC readmission reduction program was legislated in Section 3025 of the affordable care act (1) the program officially started on Oct. 1st 2012, two months after the final program details were published. In the first year 2217 hospitals received penalties that ranged from 0.01 % to 1% of their Medicare revenue generated during FY 13 ( Oct 2012 to Sept. 2013).
The readmission penalties are expected to rise as more diagnosis are being added to the group for penalties.
Value of TeleHealth on reduction of readmissions:
When smart phone Technology is being introduced widely to reduce readmission rates, among the Medicare population, how many > 65 Year olds have smart phones?
The answer is surprising, one out of six seniors in the lowest income category has smartphones.
Reducing readmissions within non smartphone users: By educating patients throughout the stay and beyond: One of the approach we have is that our RN Coordinator engages with patients and caregivers from the beginning of the hospital stay and starts imparting relevant disease specific education.
National statistics say that only 42% of patients are able to state their diagnosis at the time of discharge and only 37% are able to state the purpose of their medications. In order to take control of their health and wellbeing, patients must have a baseline of health literacy. A visit to the hospital is an ideal time to begin that process by asking core questions such as, "why have you been admitted?" "What is happening to your body?" "How can you recognize future symptoms?" Inspinary RN Care Coordinator starts communicating with the patient from the day patient is admitted to hospital. Inspinary's TeleHealth Readmission Reduction e Program (RRP) is provided to hospitals and health plans throughout the United States.
Organizing Follow Up appointments:
Patients who lack an outpatient appointment at the time of discharge represent 50% of readmitted cases nationwide. Relying on patients to make this initial appointment when they return home increases the risk that appointment setting will not happen.
A simple way to help them take this step that does not require a complicated process is to give them the date and time of the appointment after coordinating with Physicians office and the patient. This can be achieved easily by the RN Coordinator during the initial phone conversation with the patient as per the discharge instructions from the hospital. Assigned RN Coordinator also ensures that the patient has all the reminders and arrangements to reach the Physician office for the scheduled appointment. This completely takes away the guess work and once the Patient completes the visit, RN coordinator coordinates with Physicians office to schedule any further follow up, any new medications, diagnostics performed or to be performed. The information helps the RN Coordinator to keep the patient aligned with the providers care plan and adherence.