Why penalties may not be the best way to reduce hospital readmissions
In 2012, the Hospital Readmissions Reduction Program (HRRP), a part of the Affordable Care Act, went into effect, resulting in penalties for hospitals that had excessive readmissions for specific conditions, such as pneumonia, myocardial infarction, and heart failure. On the surface, it appears that hospital readmission penalties have helped the program reach its goal – reducing readmissions. But a closer look uncovers some troubling data.
One report by the University of Michigan showed that a reason hospitals are cutting their readmissions is because they’ve changed the way they’re describing patients when submitting claims data. Hospitals can describe patients as sicker, increasing risk adjustments and reducing their hospital readmission penalties.
Researchers at Harvard and UCLA recently released a study with data that’s even more troubling. The study found a link between reduced readmissions and increased 30-day and one-year mortality rates, particularly within heart failure patients. While readmissions have been reduced, these findings show that current methods of reducing readmissions may be jeopardizing the health of patients and “reducing readmissions for readmissions’ sake” may not be the right objective.
Both of these studies suggest that hospital readmission penalties may not be the best way to reduce hospital readmissions. Here’s a closer look at reasons penalties may not be sufficient and some helpful suggestions for hospitals who want to reduce readmissions while improving patient safety and satisfaction.
Penalties are Imposed without Providing Health Systems with Solutions
Motivational methods fall into two categories: the carrot method and the stick method. The carrot method offers positive reinforcement, offering a reward for wanted behavior, while the stick method is negative reinforcement, penalizing unwanted behaviors.
The stick method doesn’t work well long-term. It’s a short-lived method that doesn’t offer long-term results and doesn’t help organizations realize their full potential. Holding organizations accountable for achieving certain goals without providing the guidance and resources to effectively achieve those goals can result in consequences such as higher mortality rates, which isn’t the intended result.
The Affordable Care Act brought about penalties for hospital readmissions, but it’s never given healthcare systems solutions to help them bring down readmission numbers safely.
According to a Beth Israel Deaconess Medical Center cardiologist, Robert Yeh, M.D.: “Bad health policies” have the potential to have some side effects that are unanticipated, just like bad medications. Unfortunately, when imposing penalties without offering real solutions, the patients may be the ones paying the price.
Rewarding positive changes and providing sufficient guidance offers a better method for reducing hospital readmissions. Instead of making hasty changes out of fear of penalties, rewards allow hospitals to move in a positive direction to achieve results that not only get rewarded, but also make their hospital better as a whole.
Effective Patient Engagement Could Be a Driver for Fewer Hospital Readmissions
It’s easy to see some of the reasons why hospital readmission penalties may not be the right way to reduce readmissions. But we do know that excessive readmissions are a problem. What can be done to reduce those readmissions safely?
One answer: Implementing more effective patient engagement that influences positive health behaviors. Even if HRRP didn’t impose penalties for excessive readmissions, reducing readmissions should be a goal for every health system. Lack of effective post-discharge patient engagement increases the risk of readmission, while better engaging patients during their hospital stay and post-discharge offers improved health outcomes, ultimately reducing readmissions.
Using a digital patient engagement platform, such as PatientBond, offers a way to engage patients after discharge without increasing the workload for healthcare staff. The platform allows health systems to set up two-way communication with their patients via text, voice response, or email. The platform utilizes psychographic segmentation to tailor messages to each patient based upon their motivations and beliefs.
PatientBond has worked with multiple health systems, effectively reducing readmissions for spinal surgery, congestive heart failure, and more. With precision patient engagement and the use of psychographic segmentation, healthcare professionals are able to build relationships with patients and identify the ones that may have a greater risk of readmission.
While reducing readmissions is important to avoiding penalties, implementing solutions like improved patient engagement with PatientBond goes beyond simply reducing hospital readmission penalties. It offers better patient satisfaction and improved patient outcomes, which is something every healthcare system should be working toward.