Since October, Medicare has been calculating the number of
Medicare patients readmitted to hospitals within 30 days of their discharge.
This data is kept for the new Value Based Purchasing Program, a part of health
care reform (HCR) that penalizes hospitals with high rates of readmission by
withholding a part of their reimbursement money.
The program has begun to change the payment structure of
Medicaid away from government payments to hospitals per procedure, and towards payments
for the overall wellness of the patients. These changes are a welcomed change
by many patients, and even by some health care professionals who believe that
this is the way hospitals will be paid in the future.
As a result, some hospitals have been employing new
techniques to ensure that patients are able to care for themselves at home. According
to an article in the
Waco (TX) Tribune, some hospitals in Texas will have a nurse call the patient
at home to follow up on their recovery and ask if there is anything the patient
needs. Others will automatically schedule a follow up appointment with the
patient’s doctor. Still others may send health care professionals to the patient’s
home to ensure a smooth transition.
Many hospitals employ a discharge questionnaire that asks
questions such as “will there be a friend or family member to assist you at
home,” “Are you able to get to the pharmacy,” and “do you understand any changes
in medication?” While these questionnaires have been in place for a while in
many hospitals, some have tweaked the questions in an effort to prevent
readmissions.
The program, combined with the resulting changes in hospital
procedure, mark a significant change in hospital culture. This change will be
important over time, as penalties for readmissions only escalate in the coming
years.
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