There is no question that the healthcare system in the US has been needing serious overhauling for a long period of time. When you consider the effect of the rising senior population and their possible need for extended bouts of medical care, there is no question that the system is in need of attention right now. 
The Centers for Medicare and Medicaid,or CMS, is a department within the U.S. Department of Health and Human Services that is responsible for the administration of a number of key health care programs that include Medicare, Medicaid, Children’s Health Insurance Program, as well as the Health Insurance Portability and Accountability Act.
In October 2012, the Affordable Care Act added a new program, the Hospital Readmissions Reduction Program, which has required CMS to decrease the payments to any hospital that has excessive rates of readmission. Readmission is referred to as a reentry into a hospital, the same one or another location, in a period of 30 days from the date of discharge. Pneumonia, heart failure, and myocardial infarction (a heart attack) are just a few of the number of diagnosis that have been targeted.
As a penalty for excessive rates of readmission, there will be a reduction in the facilities reimbursement from the programs that are covered by the CMS program.
As a provider of in home care service for seniors in Santa Clarita, we here at Comfort Keepers have put together some information about how the high cost of hospital readmission affects seniors.
Understanding How This Affects Seniors
Back in 2010, it was reported that one out of every eight Medicare patients ended up being readmitted within 30 days after their surgery, and one out of every six readmitted after they received any type of medical care. The rates of readmission are costing Medicare approximately $17.4 billion each and every year.
There are a number of different theories regarding what will cause readmissions in a hospital, especially with senior individuals. While the readmission of an elderly loved one may be an expensive statistic for certain hospitals, obviously the seniors who are readmitted are still in need of medical services. This means that as a family caregiver, you should make it a priority to ensure your seniors care and well-being once they return home.
Improving the Transition for Better Health
One of the biggest gaps that may lead to higher hospital readmission rates for senior individuals is the actual discharge process when they are leaving the hospital. Problems that may occur during discharge include:
- Proper patient education is not discussed and not clear to the dispatched to the individual.
- No referrals for community resources are provided leaving an elderly individual on their own to make arrangements for the prescribed care.
- Patients that are high risk are never identified.
- No type of follow up is offered.
How to Increase the Chances of Success
The majority of healthcare organizations have now started programs to decrease the readmission rate in an elderly individuals. This is due to a concern for the person’s well-being, as well as the facilities bottom line (every instance of readmission may lead to a negative impact for their own reimbursement). The steps that have been taken to reduce readmission include:
- Increased vigilance.
- Implementation of education programs.
- Making appointments on behalf of seniors.
- Helping patients to understand more clearly their role for their own care.
- Providing education in addition to instructions.
When you have a senior loved one who is discharged from the hospital, as a family caregiver you must put in effort to ensure their continued well-being. If you need assistance in providing day to day care, contact Comfort Keepers in Santa Clarita for some helpful information.
Comfort Keepers
23900 Lyons Avenue
Santa Clarita, CA 91321
661-287-4200
