Reducing the Overall Cost of Providing Care by Lowering Readmissions
The 2010 Affordable Care Act established a Hospital Readmissions Reduction Program whereby the Inpatient Prospective Payment System (IPPS) payments would be reduced to hospitals for excess readmissions beginning on or after October 1, 2012. A hospital opened on July 6, 2012. For fiscal year (FY) 2013, that hospital had a 30-day Composite Readmission score of 21.1% for heart failure (HF), acute myocardial infarction (AMI), and pneumonia (PN). The need to provide better transitions of care for patients was recognized at this hospital.
The hospital was to reduce costs by decreasing the 30-day composite readmission rate from 21.1% to 15.9% by March 31, 2014, by focusing on improved transitions of care.
- Implementation of Care Transitions Advocate (CTA) role for AMI, HF, and PN patients
- Scheduling follow-up appointments for AMI, HF, and PN patients
- Facilitation of weekly Readmission Taskforce
- Collaboration with pharmacy and nursing to improve medication education
Through improved processes and heightened focus on readmissions, this hospital produced a cost savings of $337,057 in FY14. Overall cost of providing care was reduced by $786 (per readmission encounter) from FY13 to FY14 and admissions grew 26.1% with actual readmissions dropping 40.2%.
A pharmacy technician for medication reconciliation presented this project at a system Medication Reconciliation steering committee; subgroup for workflows – emergency department to inpatient. This project was presented at the American Case Management Association conference in Chicago, IL in April 2014 and won award for Evidence Based Practice.