Healthy Savings

Reducing Medicare Readmissions Will Keep Down Costs, Help Patients

Maryland is a recognized leader among the states when it comes to health care. The excellence of care provided in Maryland institutions brings national prominence and economic strength to the state, and Marylanders have better access to primary care than residents of almost every other state in the nation, according to "America's Health Rankings, 2008."

But Maryland also leads the country in the rate of hospital readmissions among Medicare patients. According to a study recently published in the New England Journal of Medicine, 22 percent of Medicare patients in Maryland - more than one in five - are readmitted to the hospital within 30 days of being discharged.

Transitions from hospital to home can be complicated and risky, especially for individuals with multiple chronic illnesses. Faced with complex, costly treatments - and often conflicting instructions from different health care providers - people with chronic conditions and their family members often struggle to coordinate care and get appropriate help. This lack of coordination can lead to medical errors, unnecessary tests, avoidable hospital stays, and stress for patients and their families.

It also drives up Medicare costs. In 2004, Medicare spent an estimated $17.4 billion on potentially avoidable re-hospitalizations nationwide.

Too many people are leaving the hospital with a handful of prescriptions and little else. It's weighing on our health and driving up the cost of health care for all Americans.

One way to improve outcomes while reducing costs is to establish a Medicare follow-up care benefit. This benefit would support patients as they transition from the hospital to their own home or another setting, such as a skilled nursing facility or rehabilitation center.

Under a follow-up benefit, a team of professionals working with patients and their family members could provide transitional care services including: a comprehensive assessment of the individual's needs (and the primary caregiver's needs); development of a care plan; a visit in the next care setting shortly after hospital discharge; home visits; help with medication management; arranging and coordinating community resources and support services; and accompanying the individual on follow-up physician visits.