Integrated Healthcare News

Three-Quarters of Hospitals Face Readmission Penalties

More than three-quarters of hospitals assessed by Medicare will be penalized for readmitting too many patients.

Data for more than 3,400 hospitals released in August showed more than 2,600 of them—a whopping 76%—exceeded national 30-day readmission averages for discharged patients with key conditions. Those hospitals may consequently lose up to 3% of their Medicare reimbursements.

Medicare has also added two more conditions (hip/knee replacement and COPD) to the three originally designated for readmission reduction (pneumonia, heart attack, heart failure). It predicts the penalties associated with these patients will cut overall hospital payments in fiscal year 2015 by 0.2% from 2014 levels. The measures are based on readmissions between July 1, 2010, and June 30, 2013.

Crain’s Chicago Business examined the law’s impact in Illinois, where only 7 of 127 acute-care hospitals will avoid penalties. The state’s most-penalized institution is Ingalls Memorial Hospital in Harvey. With higher-than-average readmissions for all five conditions, it will face a 2.94% cut to its reimbursements, more than double its penalty for FY14. Ingalls’ internal data shows a reduction in Medicare readmissions from 24.3% to 22.2%, but per CMS, the national all-cause readmission rate in 2012 was 17.8%.

Ingalls has established partnerships with other local hospitals, community organizations and skilled nursing facilities to collaborate on reducing readmissions using mechanisms like health coaches visiting discharged patients. “The whole concept around a transitions program is that it’s not all about the hospital,” the hospital’s VP of patient services, Kathleen Mikos, told Crain. “We have to create partnerships in the community to help (patients) self-manage at home.”

In 2011, around 12% of Medicare admissions resulted in potentially preventable readmissions within 30 days. These cost taxpayers an estimated $17 billion a year.

AHRQ Offers Readmission-Reduction Guide, Tools

The Agency for Healthcare Research and Quality (AHRQ) has released a new guide and tool kit of best practices to help hospitals reduce their readmissions of Medicaid patients.  

The guide suggests establishing “cross-setting partnerships” with other healthcare and community resources willing to participate in team-based strategies to address such patients’ clinical, behavioral and social services needs. This cross-continuum team should involve entities that serve a high volume of Medicaid patients and are motivated to reduce unnecessary readmissions.  

Compiled by a team led by Amy Boutwell, MD, of Collaborative Healthcare Strategies, the guide overviews the readmission issue and provides a roadmap of tools in areas like data, transitional care processes, collaboration and enhanced services for high-risk patients. It provides tools for data analysis, readmission review, team inventory and participation, readmission risk, whole-person assessment and discharge, among other purposes.

For more, see https://www.ahrq.gov/professionals/systems/hospital/medicaidreadmitguide/index.html.

NAEMT Video Promotes Mobile Integrated Healthcare, Community Paramedicine

A new video from the National Association of Emergency Medical Technicians (NAEMT) provides EMS and other healthcare professionals an up-close look at how mobile integrated healthcare and community paramedicine (MIH, CP) programs work and impact U.S. healthcare.

The video, entitled Transforming EMS: Mobile Integrated Healthcare and Community Paramedicine, introduces MIH and CP programs that show effectiveness in improving patient health and controlling costs. It depicts their providers delivering care and includes feedback from patients and healthcare executives who support a greater EMS role in collaborative programs.

“Answering 9-1-1 medical emergencies will always be a key part of the EMS mission,” says Matt Zavadsky, chair of the NAEMT’s MIH-CP Committee, “but with mobile integrated healthcare and community paramedicine, EMS is showing that EMTs and paramedics can actually help prevent 9-1-1 calls, whether it’s navigating patients to destinations other than the emergency department or bringing care into their homes after hospital discharge.”

For more, see:

• www.emsworld.com/news/11653143;
• www.naemt.org/MIH-CP/MIH-CP.aspx;
• https://www.youtube.com/watch?v=iCTZI47aRss.

Additionally, to learn more about MIH-CP, attend the Mobile Integrated Healthcare Summit during EMS World Expo, November 9–13 in Nashville.

FDA Won’t Review Low-Risk Medical Devices

Draft guidance released in August by the FDA would exempt many low-risk medical devices from premarket 510(k) review, including some mobile applications that let smartphones be used for medical purposes.

An estimated 500 million smartphone users around the world are expected to be using some kind of healthcare app by next year, including healthcare professionals and patients. The FDA supports the use of apps that provide information and help improve healthcare, and in 2013 issued its Mobile Medical Applications Guidance for Industry and Food and Drug Administration Staff. This says the FDA will focus “only on the apps that present a greater risk to patients if they don’t work as intended and on apps that cause smart phones or other mobile platforms to impact the functionality or performance of traditional medical devices.”

Still subject to regulation are mobile medical apps that work as accessories to regulated medical devices or transform a mobile platform into a regulated medical device.