The Hospital Readmission Reduction Program (HRRP), which is managed by the Centers for Medicare and Medicaid Services (CMS), reduces payments to hospitals with excessive readmissions. High readmission rates can contribute to significant damage to a hospital’s financial health. What actions can hospitals take to lower readmissions?
The Agency for Healthcare Research and Quality estimates patients readmitted within 30 days cost the healthcare system more than $41 billion. Medicare beneficiaries account for more than half of this expense, including $17 billion spent on unnecessary hospital visits, according to the Center for Health Information and Analysis.
A significant contributor to hospital readmissions is inaccurate diagnosis and inappropriate treatment, including the use of excess antibiotics, unsuitable treatment, and poor selection of medication or treatment.
The Hospital Readmission Reduction Program (HRRP), which is managed by Centers for Medicare and Medicaid Services (CMS), reduces payments to hospitals with excessive readmissions. When assessing hospital performance, CMS puts particular focus on several conditions, including:
- Acute Myocardial Infarction
- Chronic Obstructive Pulmonary Disease
- Heart Failure
- Pneumonia
Why those conditions? Because they contribute significantly to hospital readmission rates. Studies have shown that 35% of heart failure patients are readmitted within 30 days. Ten percent of patients diagnosed with Acute Myocardial Infarction (AMI) are readmitted in that timeframe. While 22% of patients treated for pneumonia return to an inpatient hospital setting within a month.
Of all readmissions for those conditions, 61% occurred within 15 days of hospitalization. Longer term, the yearly rate of rehospitalization was even higher for heart failure, myocardial infarction and pneumonia.
How can an inpatient telemedicine program help?
Numerous studies have demonstrated that in-hospital consultation with the appropriate specialist improves outcomes for hospitalized patients and lowers the possibility for readmission. For example, patients who received early intervention from an infectious disease specialist were less likely to be readmitted after discharge. These patients also had lower total healthcare spending.
Many smaller hospitals can’t justify a fulltime onsite specialist in infection diseases, pulmonology or cardiology. These hospitals either do not have the patient volume to support specialist care 24/7/365 or the hospitals can’t afford to attract and retain these providers. This is where telemedicine for pulmonology, neurology and other specialties can save the day.
Telemedicine can provide access to these specialists. Eagle Specialists act as members of the medical team, consult directly with the patient, and respond on-demand. Since the Specialist is shared among several hospitals, often within the same health system or region, the cost of retaining the provider is reduced. By implementing a telemedicine program, hospitals can provide a sustainable, cost-effective solution and offer needed specialist patient care.
Remote physicians are able to access all the information required to diagnose and treat the patient including patient medical records, vital information and diagnostic scans. Eagle’s providers interact face-to-face with the patient. This on-demand access to specialists enables hospitals to reduce physician burnout, nighttime staffing issues, and specialist shortages.
Read more about how telemedicine can reduce readmissions:
- Should hospitals increase access to specialists to lower hospital readmissions?
- Can reducing hospital patient transfer lower readmission rates?
- What’s the impact of physician burnout on readmission rates?
- Can hospitals reduce 30-day readmission rates by accessing specialist consults in the ED?
- Will improved discharge procedures lower hospital readmission rates?
