Preventing Hospital Readmissions of Medicare Patients

Most of us have heard the predictions that Medicare will run out of money at some point in the future, most recently the prediction was in 2026. One way to save money for Medicare is to reduce hospital readmissions. Thus, hospitals are actively engaged in looking at ways to reduce readmissions of Medicare patients.

Under the Affordable Care Act, Medicare is able to fine hospitals if they have too many readmissions of Medicare patients within a 30-day period. Thus hospitals are working hard to make your discharge safe.

Colorado hospitals are actively engaged in working with patients to reduce readmissions. The Colorado Foundation for Medical Care recently reported a 10% reduction in readmission of Medicare patients in a project in northwest Denver. The northwest Denver project actively involved Medicare beneficiaries by having them keep personal health records, educating them about the “red flags” so they could seek proper follow-up care, ensuring the right medications, and helping with follow-up with the primary care physician.

Other hospitals are using strategies such as hospital visits by social workers and others to develop a plan following hospitalization to ensure proper supports such as durable medical equipment, home care, and correct medications are available at the time of discharge. Hospital visits may be followed up with either additional home visits or phone calls to determine if additional assistance is needed by the Medicare beneficiary and to secure those services as quickly as possible.

The Cleveland Clinic advises that patients should know their medications and why they are taking them as well as the side effects so they can be aware of when to seek additional assistance from a health care professional.

Getting prescriptions filled immediately is not only important, but making sure that you know which prescriptions to take that you had prior to hospitalization and which ones to discontinue when you get home is also critical to regaining your health. Over medication is one of the leading causes of hospital readmission.

Often engaging the services of a visiting nurse is helpful to ensure you are taking the right medications. Medicare may pay for a visiting nurse and home care, so ask your physician to write a prescription for home care. Never refuse services the hospital offers to make your discharge safer and easier.

Patients are usually anxious to get out of the hospital and so do not share their feelings about being fearful they cannot manage when they return home. Thus, as a patient you are encouraged to share your concerns with your doctor or the hospital staff. Leaving too early or without proper planning may result in an unwanted readmission.

Leaving the hospital can be very confusing as nurses are giving you discharge instructions and asking you to sign papers. Two strategies that can help are to have a friend or relative present to listen to the discharge instructions and second to get all of the instructions in writing, so you can refer to them when you get home.

As a Medicare patient you can do your part to reduce hospital readmissions and preserve the Medicare Trust Funds by following discharge instructions, securing the help you need and reporting changes in your health to your primary care physician immediately.

If you feel that you are being discharged too early from the hospital and that your health would be jeopardized, you can call the Colorado Foundation for Health Care at 303-695-3300 and file a complaint. While the complaint is being investigated, you are not responsible for any of the charges.

If you have questions or concerns, you may call 303-33-3482 and talk with one of our counselors.