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In the event a patient goes to the hospital, be sure to communicate with the hospital staff. Send the hospital copies of the current Plan of Care/485, medication profile, and transfer summary. Be sure the transfer summary provides correct and adequate information on the patient’s health status.
We studied hospital discharges from 1995 through 2009 and found that blacks in every age and sex subgroup had significantly higher rates of hospitalization for CHF than did whites. For both women and men, the ratio of the rates for blacks compared to the rates for whites was highest in the youngest age group (~6.5) and lowest in the oldest age groups (~1.5). Our results generally confirm recent findings demonstrating a significant declining linear trend in CHF hospitalizations for people aged 65 or older.
Preventing Re-hospitalization in the Home Health Patient
The most important point here is that these re-hospitalizations can often be avoided. By implementing these changes, you can decrease your patient’s risk of unnecessary re-hospitalizations greatly. Not only will this benefit your patients, it will benefit your agency in the near future as Medicare recognizes your high quality services and rewards your agency accordingly.
In the current Home Health environment, efficiency, quality, and cost-effectiveness have become a primary focus. Due to an increase in utilization, and attendant cost increases, home health care has become a target for cost reduction by Medicare. As the government zeroes in on cutting unnecessary expenditures, agencies are being monitored for several quality indicators, one of which is how well we perform in keeping patients out of the hospital.
Workforce Data Center
Reconcile the patient’s medications on discharge against the medication profile prior to hospital stay. Provide intensive teaching on the primary disease process that caused the hospitalization as well as any new and/or changed medications. Increase the frequency of visits for a couple of weeks to keep a close watch on the patient status. Age- and sex-standardized rates also show that blacks had higher rates of hospitalization for CHF than did whites .
For the 1995 through 2007 data, the sample included 501 to 525 hospitals; the average unweighted response rate was 89%. In 2008 and 2009, NCHS had only enough funding to collect data from 239 hospitals; the unweighted response rates were 86% to 87%. At the final stage of sampling, the NHDS selects a systematic random sample of inpatient discharge records from each participating hospital, representing approximately 1% of all hospitalizations in the United States. “Hospitalizations account for nearly one-third of the total $2 trillion spent on health care in the United States.” A significant fraction of these hospitalizations are re-hospitalizations occurring soon after discharge. Re-hospitalizations result in increased costs to the payer, and potential negative impacts on patients related to complications of being hospitalized.
Data source and definitions
You can find detailed specifications for the claims-based measures in theDownloadssection below. Risk adjustment is not considered to be necessary for process measures because the processes being measured are appropriate for all patients included in the denominator . Perform an accurate and thorough assessment of the patient’s health history, support system available, knowledge of disease processes and medications, and economic status on admission. If a patient cannot understand why he or she is ill, if they have inadequate resources needed to get to and from the physician or to purchase prescribed medications, for example, other efforts to meet the patient’s goals will be slow and tedious. From remote monitoring to more frequent visits, HHAs need reliable and scalable processes for keeping patients healthy and out of the hospital.
(The ACA was not only in response to millions of Americans being uninsured but also to the “lack of guaranteed basic level of care and quality of care”) . Before implementation of the Patient Protection and Affordable Care Act, we found that blacks were disproportionately affected by preventable CHF hospitalizations compared with whites. Our results confirm recent findings that preventable CHF hospitalization rates are declining in whites more than blacks. We used National Hospital Discharge Survey data from 1995 through 2009, which represent approximately 1% of hospitalizations in the United States each year. It is time to address the actual causes of re-hospitalizations of nursing home residents by providing better health care in SNFs.
About CMS
The pilot facilities reported an average reduction of hospitalizations of 50% over the six-month period. Home care strategies add value to care for organizations and providers that take on high-risk populations that also experience high rates of readmissions. Common goals of these strategies are to keep individuals within these populations healthy, divert emergency department visits and hospital readmissions as well as improve their overall quality of life. Telehealth can only go so far in terms of the care that takes place in a doctor’s office. The eyes and ears of a home health medical professional streamlines care coordination—a critical component of value-added care for high-risk populations—which ultimately prevents acute conditions that warrant ED or in-patient care.
Potentially avoidable events serve as markers for potential problems in care because of their negative nature and relatively low frequency. The potentially avoidable events reported are outcome measures, in the sense that they represent a change in health status between start or resumption of care and discharge or transfer to inpatient facility. All the potentially avoidable event measures are adjusted for variation in patient characteristics.
You could make your own clothes if you wanted to and had the time but you do not need to; simply shop for the clothes that best fit you and your needs. After meeting your basic needs like underwear, socks and pants you can customize your own style and preferred fit. I would recommend that you perform an internet search on “best practices for preventing re-hospitalizations” and identify the approaches that are right for you. I will review just a couple here so you get the idea of some of the resources available. Today, thanks to financial penalties for readmission’s within 30 days for certain diagnoses, hospitals now have the incentive to actively assist us with this effort.
The intention of the ACAs HRRP is to protect healthcare consumers as well as preserve the nation’s funding for Medicare beneficiaries through value-based reforms. The startling amount of Medicare reimbursement monies that go to readmissions make some experts fearful for the longevity of the Medicare Part A program. Waste, such as preventable re-hospitalizations, plays a big part in the problem. CMS reporting in 2019 indicates that the HRRP implementation is not enough to prevent readmissions. Eighty-three percent of the 3,129 hospitals that were part of the program received a penalty.
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