The Top 4 Mistakes Hospitals Make That Drive High Readmission Rates
Nearly 3,000 hospitals face penalties for preventable readmissions under the Centers for Medicare and Medicaid Services’ Hospital Readmissions Reduction Program (HRRP). For most, the penalties will be smaller than in previous years, but 49 will be hit with the maximum 3 percent reduction in Medicare payments for Fiscal Year 2017.
Some argue that this year’s figures reflect the broader scope of covered conditions and that overall readmission rates are improving. Based on the numbers, however, it is clear that hospitals still have their work cut out for them if they want to correct their course in efforts to reduce readmission rates. What issues do they need to address?
1. Not identifying the root causes of readmissions
The root causes of readmissions often boil down to racial, ethnic or socioeconomic disparities. As Fierce Healthcare points out, CMS has indicated that, “Racial and ethnic minority populations are more likely than their white counterparts to be readmitted within 30 days of discharge for certain chronic conditions, such as heart failure, heart attack and pneumonia.”
During a hospitalization, patients—and their
family caregivers—feel overwhelmed. It’s not a state that’s conducive to focusing on complicated educational materials or discharge instructions.
Overcoming these types of obstacles isn’t easy, but it can be done. How? Customizing communications to address lower health literacy and language barriers, as well as collaborating with trusted community resources to bridge gaps in transportation for filling prescriptions or attending follow-up visits, can help.
2. Not providing clear discharge instructions
Non-compliance with discharge instructions — from not keeping up with medication to missing follow-up doctor’s visits — can hamper recovery, leading to readmissions. But you can’t lay all the blame at the patients’ feet. During a hospitalization, patients — and their family caregivers — feel overwhelmed. It’s not a state that’s conducive to focusing on complicated educational materials or discharge instructions. They need to be given easy-to-digest instructions and have continued access to those tools after they leave the hospital.
One hospital decreased readmissions by more than 14 percent by using a mobile app that lets patients access audio and video discharge instructions at their convenience. The decision to take this approach was based on a study by the Agency for Healthcare Research and Quality (AHRQ), which found recorded instructions helped reduce preventable readmissions. Additionally, PatientBond leveraged emails and text messaging to achieve only ONE readmission in nine months during an ongoing program at a prestigious Massachusetts hospital. Automated reminders about discharge instructions can also spur patients to stay compliant.
3. Not making the most of technology
Telemedicine, remote monitoring and other types of technology can give hospitals a leg up when it comes to lowering readmission rates. But as Chilmark Research pointed out in its 2015 “Migration to Connected Health” report, “The notion that simply discharging patients with some technology will prevent readmission or ensure positive outcomes is more wishful thinking than reality.” The report noted that mobile technologies such a mobile electrocardiograms offer convenience, but warned, “… they can be tricky to use correctly and consistently with a single patient—let alone across a population.”
The use of psychographic segmentation helps hospitals better understand how to engage and motivate patients to improve discharge plan compliance and health outcomes.
As these technologies mature, we can assume they will become easier to use, but in the meantime, hospitals must recognize that a large number of patients at risk of early readmission are older and less tech-savvy, so any technology they employ must be user-friendly.
4. Not communicating with patients effectively
After examining six years of data from close to 3,000 hospitals, researchers from the Harvard Business Review determined that effective patient communications exert the greatest influence on lowering readmission rates. The article notes, “In fact, the results indicate that a hospital would, on average, reduce its readmission rate by 5% if it were to prioritize communication with the patients in addition to complying with evidence-based standards of care.”
How do you communicate effectively? By understanding each patient on a deeper level, and customizing your communication plan to speak to their needs, expectations and preferences. The use of psychographic segmentation helps hospitals better understand how to engage and motivate patients to improve discharge plan compliance and health outcomes. When used in combination with an automated patient engagement platform like PatientBond, the end result is a consistent, relevant stream of communications that help you identify and manage patients with the highest risk of readmission more efficiently and effectively. The earlier example citing PatientBond’s success in reducing readmissions is a case of using psychographic messaging to resonate more strongly with patients.