The rate of hospital readmissions in Ohio fell dramatically over the past five years, corresponding with Affordable Care Act initiatives designed to reduce avoidable hospital stays, new federal data shows.
From 2010 to 2015, the 30-day hospital readmission rate tracked by Medicare fell by 10.6 percent in Ohio, which tied with New York for sixth-fastest decline in readmissions and is one of only 11 states that saw readmission decline by more than 10 percent over the past five years, according to figures from the Centers for Medicare & Medicaid Services (CMS).
Readmissions have been singled out as one of the biggest problems facing the hospitals because they’re expensive, bad for patient health and a burden for caregivers and families.
Still, every state except Vermont saw a drop in readmissions, translating to about 565,000 readmissions avoided since 2010 and millions of dollars in savings in taxpayer-funded Medicare reimbursements.
The overall decrease in readmissions was reflected in the rates for local hospitals as well, including the two biggest hospital systems in the Dayton area: Premier Health, and Kettering Health Network
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Dr. Tammy Lundstrom, chief medical officer for Dayton-based Premier, said the hospital system has been working diligently over the years to help patients get better follow-up care after they’re discharged, reducing unnecessary readmissions systemwide by about 300 to 350 a year.
“The hospital is not the safest place to be, unless you’re really sick, and need to be there,” Lundstrom said. “We know that the best thing for patients is to get care in the least intense setting, so we really work very hard and with a lot of community partners on making sure that we get patients what they need.”
About 80 percent of avoidable readmissions stem from social determinants, such as a lack of access to primary care doctor, or transportation to get to a doctor or get prescriptions filled, Lundstrom said.
To address those issues, Premier connects its patients with so-called “navigators” whose job is to help those patients find a primary care physician or clinic if they don’t already have one, help them keep doctors appointments, fill prescriptions and otherwise keep them healthy and out of the hospital. Lundstrom described the navigators as “the first person patients should call when they need something.”
At Springfield Regional Medical Center and Mercy Memorial Hospital, readmissions are the lowest they’ve been all year and continue to be a focus for the hospitals, according to Dave Lamb, a spokesman for the hospitals’ parent, Community Mercy Health Partners.
“We are below the national average for hospital readmission, (and) we’ve undertaken several intentional initiatives to directly address this issue,” Lamb said, referring to such things as the Chronic Care Clinic at Mercy Memorial that launched in the spring last year and quickly reduced hospital readmissions by 75 percent.
“We’ll be doing something similar in Springfield this fall with the new Health Resource Center,” Lamb said.
The focus on preventing readmissions has been driven largely by the Hospital Readmissions Reduction Program created by the Affordable Care Act.
The program was created under the idea that unnecessary readmissions are a sign of poor quality care, and it penalizes hospitals up to 3 percent of their Medicare reimbursements for having excessive readmissions.
CMS estimates it will penalize more than 2,500 hospitals — more than half those in the country — for excess readmission in the coming fiscal year, holding back about $538 million in reimbursements.
But Lundgren said most hospitals are trying to do the right thing, and aren’t just motivated by the financial incentive.
“If hospitals wanted to game the financial system, they’d take the 3 percent penalty and get the payment for taking care of the patient,” she said. “So I think this really is a case where hospitals have stepped up to the plate to try to connect people with community resources, which is a good thing.”