Health Care Reform: Ending Hospital Readmissions

You have to really dig hard to find out what the government is doing to make health care "affordable," one of the goals everyone from Barack Obama on down cites in undertaking health care reform.

But I bet you didn't know that Medicare wants to end hospital readmissions, especially in the 30 days after the first hospitalization. CMS, the Centers for Medicare and Medicaid Services, is looking at various carrots and sticks to bring down the 18-percent average rate of readmissions in the first 30 days. Lowering readmissions by 75 percent would save $12 billion a year, CMS claims.

Carrots include paying bonuses to hospitals that cut their readmission rates, and sticks include reducing or denying payment for certain readmissions deemed to be the hospital's fault.

Now, all this gets scary if you read my posting from yesterday about how hospitals in Great Britain removed wheels from gurneys so they could call them hospital beds and avoid looking like their emergency rooms were clogged and inefficient.

I'm trying to think of clever ways hospitals here could bring down the readmissions rate. One doctor I read even suggested just keeping everyone in the hospital for 30 days.

Perhaps hospitals could create a readmissions clinic and call being there something other than an admission. I've got it--put patients in gurneys in the ER so you don't have to say they've been "admitted" or "readmitted" to the hospital! What was Britain's curse could be our hospitals' savior.

Anyway, on a more serious note, hospitals have had some success by assigning coaches to each patient leaving the hospital. Coaches keep in touch with the patients--and even visit them at home--to make sure they take their medications properly and follow all parts of the regimen assigned them, including diet, rest and exercise.

With my cynical mind, however, I can still see hospitals coming up with some way around the rule, just like their cohorts in Great Britain did.