For over a decade one of the most focused on terms in hospitals was “length of stay”, or LOS. This term identifies how long a patient is in a bed as an inpatient. With the introduction of DRG’s, how long a patient was admitted had a significant effect on the revenue for a hospital.
Now with changes being implemented by CMS, (Readmission Payment Reduction Program)which centers on aggressive reduction of re-admissions, I believe the primary focus will, and should, shift to preventing avoidable hospital readmissions. Hospitals could receive up to a 3% reduction on all Medicare payments based on the 30-day readmission measures for heart attack, heart failure and pneumonia starting in 2013. This approach makes it clear that this is not only a clinical concern, it is a financial issue as well.
Starting in 2015, the HHS Secretary can add other conditions to this list as they feel is appropriate. I would put money on wound and skin related issues to make that 2015 list. With nearly 20% of Medicare fee-for-service beneficiaries discharged from a hospital being readmitted within 30 days and 34% readmitted within 90 days, a solid plan is needed at every hospital.
Your outpatient wound care center can offer significant assistance in dealing with these readmissions. Using the wound care team to identify patients with wound issues prior to discharge, they can develop a plan for continued treatment in the outpatient facility. The typical wound center will see patients once a week which can reduce the potential of these often complex patients from being readmitted. A NEJM study shows that nearly half of the Medicare patients who are rehospitalized within 30 days did not have a physician visit between the time of discharge and readmission. A wound center allows for weekly review by a physician and nursing team which helps manage patient issues and at the same time provides revenue for the hospital. Talking about a win-win proposition!
WCA is currently implementing a system which will assist in the tracking of potential readmissions and a readmission prevention program for wound patients. I think now would be a good time to implement this type of program, and certainly before 2015!