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Minnesota hospital says pilot program cuts costly readmissions

Working with UCare and Fairview Physician Associates, Fairview Southdale Hospital said it cut patient readmissions by at least 30 percent over a nine month period.

Minnesota has a well earned reputation for pioneering health-care reform. So it’s not completely surprising to see this announcement from Fairview Southdale Hospital.

Working with UCare and Fairview Physician Associates (FPA), the hospital said it cut patient readmissions by at least 30 percent over a nine month period.

From February to September 2010, only 27 patients of 292 original admissions elderly Medicare patients, many suffering from diabetes and heart disease, were readmitted to the hospital within 30 days of discharge. Fairview Southdale’s 9.25 percent readmission rate compares to a 16.5 percent rate during the same period last year.

Experts say preventable hospital readmissions are a major reason for ballooning health-care costs in the United States. About 20 percent of Medicare patients return to the hospital within a month after discharge. To fix the problem, the recently passed federal healthcare reform law provides $500 million over five years to manage care for 30 days after hospital discharge and also imposes financial penalties on hospitals with high readmission rates for certain diseases.

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Dr. William Nersesian, FPA’s chief medical officer and author of the study, said providers can prevent most hospital readmissions with simple fixes. For example, a diabetic patient suffering from shortness of breath and heart failure related-weight gain can find himself back in the hospital because he may not have family members to help him take his medications correctly, eat the right foods and weigh himself to check for fluid retention.

However, the actual execution can be tricky, Nersesian said. The pilot project required FPA nurse case managers, hospital social workers and pharmacists coordinate efforts to manage patients’ care once they leave the hospital.

“Getting all of the parties work together in an optimal way can be challenging,” Nersesian said.

Another big obstacle: everyone getting paid for their efforts. Medicare typically doesn’t pay providers for ensuring patients properly read the instructions on their pill bottles and buying the rights foods at the grocery store.

Nersesian said there’s an understanding among providers that they would have to earn less money in the short run for the long term good. In addition, the FPA’s contract with UCare pays doctors something extra if they meet performance goals, like, say reducing hospital readmissions.

That should lessen the sting.