How Hospitals Can Save Medicare Billions

There are more and more issues surrounding saving Medicare money lately, and there are a lot of ideas swirling around to make that happen.  One idea that has come to the fore and was featured in the Boston Globe is a way to help patients on Medicare, give them better service and better outcomes, and, at the same time save Medicare a lot of money – possibly half of its shortfall.  Is it possible to do all these things at once?  According to experts, it is.

One of the highest costs that Medicare is paying for is stays in the hospital.  Most of these stays are necessary, and nobody is questioning this point.  The issue at hand is that many seniors on Medicare come out of the hospital only to return again within 30 days, and in many of these cases, this could be avoided. 

Research has shown that patients return for several main reasons.  One reason is that they acquired an infection while in the hospital and it has reoccurred or flared up.  Another reason is that they are unclear about what to do upon discharge and their condition worsens because they are not following up correctly.  The third reason is that nobody has followed up with them.

Some readmissions are necessary, and nobody is disputing that fact.  However, studies show that if patients were cared for differently when they were in the hospital in the first place, there would be fewer complications, such as infection, and, as a result, a lower number of patients would return.  It has been suggested that if Medicare paid less for readmissions but gave bonuses to hospitals whose readmissions were lower in number, the outcomes for all parties would be better.  In hospitals where this was tested, the patients had less complications and readmissions, the hospitals and Medicare saved money.

In addition, helping patients understand what needs to happen after discharge is a huge factor in whether they return for readmission or not.  Having a discharge nurse or coach with easy and non-confusing instructions regarding medication and other discharge information has helped lower the readmission rate in hospitals that employed this step.  Also, having a nurse follow-up by calling the patient and discussing what is happening with them has lowered readmissions for cardiac patients in one hospital by over 75%. 

The Boston Globe article suggested that Medicare look at how it is rewarding hospitals, and reward them with bonuses when they save money, rather than paying them well to keep their beds full – even on readmissions.

With Medicare funding at question and lawmakers searching for answers, this is an important issue and the Boston Globe article makes some logical points.  Hospitals and lawmakers out there: are you listening?

Filed under: General-Medicare

Tags: complications, General-Medicare, hospital readmission, Hospitals, Medicare funding, medicare patients