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Conference puts focus on hospital progress on lowering readmissions

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Last year, Medicare started penalizing hospitals across the country that have high patient readmission rates, but in most New Jersey counties, hospitals have achieved reductions in readmissions as a result of new programs aimed at keeping patients healthy and at home following discharge.

That was the message at a daylong conference today at the New Jersey Hospital Association, in Princeton.

“New Jersey is starting to drive down its readmission rates, and I think the most important item that we’re seeing is that hospitals are starting to work together with various different health care providers, including nursing facilities and home health agencies,” said Daina Bungs, project coordinator for Healthcare Quality Strategies Inc., of East Brunswick. HQSI works with the state’s health care community to accelerate quality improvement, and is funded by Medicare.

The conference drew 180 health care professionals, who got an update from HQSI on the percentage of New Jersey Medicare patients readmitted to hospitals within 30 days of discharge. The overall readmission rate for New Jersey declined to 19.98 percent in the last half of 2012, from 21.35 percent in the last half of 2009, Bungs said.

Most of the state’s counties saw declines, and rates vary across the state. Hunterdon was the lowest, at 16.99 percent at the end of last year, down from 20.12 percent in 2009. Hudson County’s readmission rate was among the highest, at 23.99 percent in the last half of 2012, down from 25.01 percent at the end of 2009; Essex had a similar decline, to 22.92 percent from 25.27 percent.

But those levels are still above where Medicare wants them to be: Bungs said 61 of 63 hospitals in New Jersey are being penalized by Medicare for excessive readmission rates; those penalties can be as high as 1 percent of the hospital’s Medicare billings, and a typical hospital receives about half its revenue from Medicare.

“The penalties are motivating hospitals, and a lot of them are looking at different types of interventions to reduce readmissions, like coaching programs and working at improving communications with nursing facilities,” Bungs said.

One popular program, Interact, brings together various health providers in the community to work together on reducing readmissions, she said. Hospitals are also coaching patients to make sure they understand their medications and see their primary care doctor soon after being discharged.

The Medicare penalties are set to increase over time “and that is one of the biggest reasons why hospitals are keen on involving all other community partners in reducing readmissions,” Bungs said. “In some of the places where the decreases are happening faster, (hospitals) have been very aggressive in seeking out community partnerships. The challenge is that there are so many different factors that drive readmissions.”

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