Medicare Zaps Hospital Readmissions
Finally this past Monday on October 1 guess what happened folks? Medicare changed the way they’re going to reimburse hospitals when patients are readmitted for certain diseases. This is for readmissions within 30 days. Initially this is going to be limited to just a few different diagnoses.
20% of Patients Re-admitted
This policy and billing change is really focusing the fact that nearly 20% of people admitted to the hospital are readmitted within 30 days. That number is appalling and often preventable. Hospitals are complaining about this saying it’s not all their fault that patients don’t follow instructions or by chance have a complication. Whatever the reason, hospitals need to start stepping up and adjusting the way they discharge and follow up with patients after hospitalization.
This may lead back to changes in emergency medical services in a couple of different ways. EMS services may be transporting patients from the hospital to their home. We should be aware what their discharge instructions are and we should be asking them some key questions:
- Do you did you understand your instructions?
- Do you know what to watch for in the way of complications?
- Do you have your contact information for the doctor and hospital?
New EMS Assessment Questions
You may be required to ask questions like these if you work for the hospital because this billing change is going to cause hospitals to do a lot of follow-up care. They need to do a lot better job of managing these patients both at the time of discharge and when they get home.
For EMS crews, this may translate to fewer trips to the hospital. This policy is going to save time and money all the way around. Medicare looked at what this cost the system and they included the cost of readmission and ambulance transport back to the hospital. Being included in cost savings measures is a good thing because it means that EMS is being seen more as a part of the health care system and less as part of the first responder system.
EMS Integral Part of Health System
EMS needs to be included as part of the healthcare system just as I talked about in the previous news item this week looking at a system-wide approach to cardiac arrest. We need on a systemwide approach to health care reform and that includes emergency medical services care as part of the health care system. Looking for ways that you can help patients better acclimate to going home after they’re at the hospital is just one way you can help cut down on re-admissions.
Two thirds of hospitals are expected to incur some kind of penalty as a result of this change in Medicare billing and the average penalty is expected to be around $125,000 annually the first year. That penalty amount will go up as a percentage of their total Medicare billing each year for the next three years based on their rate of re-admissions. We’ll have to see how this progresses with the hospitals, but we need to be a proactive part of the system.
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For links to this news item and the full episode video and audio version of this show visit — Diltiazem ACLS Review and Episode 303.
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