The BEST Plan to Reduce Readmissions

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The BEST Plan to Reduce Readmissions

October 17, 2019

Much has been published about new CMS Medicare reimbursement penalties and the impact to hospitals, Medicare and other administrative roles.  It’s a very large impact … estimated at $563 million in reduced reimbursements to hospitals in 2020.  That presents a problem, and hospitals across the United States are taking many different paths to solve their unique issues.




Below are some different methods and the expected results from each approach:


  • Do nothing.  Many hospitals simply don’t consider these penalties to materially impact their organization in a meaningful way, or may not have any penalties to consider, or worse, may have much bigger issues to address.

    • EXPECTED HOSPITAL RESULTS:  Same or worse performance

  • Re-allocate nursing staff.  One approach is to allocate a portion of nursing time to making follow-up calls to patients after being discharged from the hospital.  The individual, personal approach is highly effective, EXCEPT for the fact that hospitals are using the most valuable, and oftentimes scarce resources to perform support functions.  Every minute an on-shift nurse spends on the phone with discharged or interacting with technology is time taken from direct interaction with admitted patients.  This scenario creates highly uncertain potential results for patients, as well as increased stress and burnout among nurses.

    • EXPECTED HOSPITAL RESULTS:  Same or slightly better performance; nurse burnout / attrition and related replacement costs

  • Technology.  Another approach includes the exclusive use of technology to connect with discharged patients.  Modern software and digital communications have proved to be an appropriate component of a patient care program.  However, the exclusive use of technology can lead to mixed results.  For instance, an automated call may not be able to adequately capture that a discharged patient’s voice is weak and perhaps that patient is not recovering in an expected manner … which assumes that the patient even answers the automated call.

    • EXPECTED HOSPITAL RESULTS:  Same or slightly better

  • Live callbacks from trained professionals.  The best approach to addressing unplanned readmissions includes trained professionals making calls to discharged patients on a pre-defined schedule.  Even with advancements in technology and new processes, the classic approach of “people helping people” has proven to be the most effective approach to reducing readmissions and improving overall patient satisfaction.  And, not only are patients more satisfied, nursing staffs are typically impacted in a positive manner due to the reduction of time spent with activities away from admitted patients.

    • EXPECTED HOSPITAL RESULTS:  Slightly better to much better

Hospitals of all sizes across the United States are affected by readmissions penalties, and how they choose to address this serious issue has a big impact on their overall performance, but more importantly, on the ongoing focus of patient care and satisfaction.

Which path should your hospital choose?  Learn more about possible program with PREMEDEX.


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