WIHI: Reducing Readmissions, Restoring Revenues: Making Good Care Count

Date: October 7, 2010

 

Featuring:

• Amy Boutwell, MD, MPP, Director of Health Policy Strategy, Institute for Healthcare Improvement
• Jeffrey Burke, Director, Financial Decision Support, Spectrum Health
• Rosemary Rotty, Director, Financial Planning, UMass Memorial Health Care

You’d be hard pressed to find anyone working in a hospital who’d say, “Yes, we really want Mrs. Jones to be back here a few days after she’s been discharged, running a fever, suffering complications from surgery, and now needing to be readmitted so we can run more tests.” And yet, scratch the surface of even the most dedicated hospital these days, working hard on sending people home with appropriate information, support, and planning… and you’ll find someone working late who’s been asked to come up with the business model that’s going to replace all the lost revenues when those “unwanted” readmissions are reduced!

Even as payers, including Medicare, are poised to make hospitals that don’t reduce their readmissions feel added financial pain, the fiscal impact on hospitals doing the right thing, right now, is already real. At times, it feels like it comes down to “choose your poison.” That’s why, experts say, hospitals have often made the unbelievable decision of throwing successful readmission reduction programs overboard, quite simply because they can’t afford the negative effect on the bottom line.

IHI’s STAAR (STate Action on Avoidable Rehospitalizations) initiative is taking a hard look at finances, working with a courageous group of hospitals that are learning how to open their books and analyze their admissions (and readmissions) patterns with some new eyes and new thinking. As with any serious commitment to improvement, knowing the facts is the essential first step. It turns out that asking one set of hard, financial questions, leads to others about utilization patterns and overall hospital operations… helping hospitals get ever closer to truly understanding how to care for patients in the right place, at the right time.

WIHI host Madge Kaplan talks with Amy Boutwell from the STAAR initiative and two hospital leaders who crunch numbers, Jeffrey Burke and Rosemary Rotty, share why it’s critically important to make the financial impact of reducing readmissions a living, breathing, part of your quality agenda.