Jul 10th 2020

For Hospitals Trying to Avoid Readmissions, It’s Time to Talk

When hospitals are hemorrhaging funds, patient readmissions are often to blame. The key to staunching the flow could be as simple as better communication with patients and post-acute care partners.

Last year, Medicare cut its acute care reimbursements to 83% of the 3,129 hospitals it evaluated as part of the Hospital Readmission Reduction Program (HRRP). This program penalizes hospitals with relatively higher rates of readmissions within 30 days for certain conditions. High readmission rates cost hospitals around $563 million in 2019.

Evidence suggests that hospitals can stay out of the penalty zone by improving patient communication. A good bedside manner has always been the hallmark of an excellent healthcare practitioner, but hospitals often focus on consistency-based processes of care delivery to a greater degree than individualized patient experiences when discharging a patient. Perhaps it's time for a change.

Researchers at the University of Ohio analyzed 6 years of data from almost 3,000 acute care hospitals. They found that communication between hospital caregivers and patients was the single biggest factor in cutting hospital readmission rates. On average, prioritizing communication with patients reduced 30-day readmission rates by 5%, the study found. The takeaway: Care doesn't begin and end at the hospital door. Rather than handing off post-acute care management, hospitals can help patients—and themselves—by staying in touch.

This communication should include pre-discharge assessments of home safety for patients, along with more aggressive monitoring of patient vital signs using either onsite home visits or remote monitoring equipment. These efforts can help spark early intervention efforts, staving off costly readmissions and penalties.

Patient education is another important post-acute care management tool. Hospitals can boost their preventative care by simultaneously educating patients and their home caregivers on issues such as treatment adherence and home safety, while introducing initiatives like fall-prevention programs.

Staff training is crucial


These steps may seem simple, but hospital efforts to include post-acute care communication into their workflows require coordination and commitment. As part of the post-acute care coordination process, hospitals should try to connect with all care management providers, including nursing facilities and home caregivers—before, during, and after discharge.

By connecting with other providers, hospitals can better manage medication reconciliation during handovers, for example, so that nursing homes and other facilities understand each patient’s care regimen. Deloitte has even recommended commercial partnerships between acute and post-acute care facilities to create patient-centric models and improve communication through the post-acute care continuum.

Hospital staff play a vital part too. Training front-line providers and administrative staff in 'soft' communication skills will help keep patients well in post-acute care environments. 

When committing to a long-term investment in the health of patients, hospitals should decide upfront how they will measure and manage the post-acute care communication and education process.

Healthcare professionals and administrators who think outside the hospital walls can help build a strong post-acute care continuum that will generate positive outcomes. For hospitals losing millions each year in reduced acute care reimbursements because of readmission penalties, a little communication goes a long way towards providing better patient care—and restoring their own bottom line.