In 2013, more than 2,000 hospitals — two-thirds of all U.S. hospitals — were penalized about $227 million for excessive readmissions by the Center for Medicare and Medicaid Services (CMS). Reducing hospital readmissions is critical for the health of patients and making the health care system more effective.
The Role of Family Caregivers
Health care experts say caregiver training and engagement is vital to improving care transitions — when patients are discharged from the hospital — and preventing costly readmissions.
Once a patient leaves the hospital, family caregivers are the front line of defense against costly hospital readmissions. Every day, these caregivers work hard to safely help their loved ones live independently at home. They:
- Help their loved ones to bathe and dress
- Administer multiple medications — including injections
- Provide wound care and perform many other complicated medical or nursing tasks
Yet, most family caregivers report that they receive little or no help in understanding how to perform these important tasks.
How The CARE Act Can Help
The Caregiver Advise, Record, Enable (CARE) Act is a basic first step to engage family caregivers in the hospital setting so they may safely provide care for their loved ones at home — care that can help prevent costly hospital readmissions. The bill:
- Allows a patient to designate a caregiver when admitted into a hospital
- Requires the hospital to notify the family caregiver before the patient is discharged or transferred
- Requires the hospital to provide an explanation and live instruction of the medical tasks — such as medication management, injections and wound care — that the family caregiver will be expected to perform at home
According to Elaine Ryan, AARP vice president of state advocacy and strategy: “While not all readmissions can be prevented, research shows hospitals can use effective strategies to avoid many of them. Patients and their family caregivers want and need to play their part in reducing readmissions, and the CARE Act is an important step that will help them share in this responsibility.”
As AARP continues to fight in states across the country to pass the CARE Act, Oklahoma became the first state in the nation to sign the act into law this year.
What Medicare Is Doing Now
CMS introduced the Medicare Hospital Readmissions Reduction Program in 2010 as an incentive for hospitals to reduce costly readmissions — and improve care. According to CMS, about 1 in 5 Medicare patients discharged from a hospital are readmitted within 30 days.
The national median 30-day readmission rate is:
- 20 percent for heart attack patients
- 25 percent for heart failure patients
- 18 percent for pneumonia patients
The goal of the CMS program is to improve quality of care and reduce avoidable illness and mortality by encouraging hospitals to invest in ways that will:
- Reduce complications
- Smooth care transitions through initiatives that engage patients and families in care planning
Hospitals with excessive readmissions face financial penalties:
- For excessive 30-day readmissions related to three conditions (heart attack, heart failure and pneumonia), Medicare payments are reduced by up to 1 percent.
- The reduction in payment rises to 3 percent in 2015 when the program expands to include seven conditions.
Find out where CMS ranks your state when it comes to costly hospital readmissions.
While not all readmissions can be prevented, research shows hospitals can use effective strategies to avoid many of them. Patients and their family caregivers want and need to play their part in reducing readmissions, and the CARE Act is an important step that will help them share in this responsibility.
If you are a family caregiver, you’re not alone.