Project reduces hospital readmissions by up to 44% in early results
Pilot aims to improve care and patient experience, reduce health care costs
Contact: Brenda Jaye, Fairview Physician Associates, 952-914-1858
Wendy Wicks, UCare, 612-676-3567
Edina (Nov. 29, 2010)—Early results of a pilot project to reduce readmissions at Fairview Southdale Hospital showed readmissions dropped by as much as 44 percent compared to those in a similar population at the hospital last year.
The good news came nine months into a pilot project designed to keep Medicare Advantage patients from returning unnecessarily to the hospital within 30 days of discharge.
Targeting diabetes, pulmonary and heart diseases
Begun Feb. 1, the pilot project is a joint effort of Fairview Physician Associates, UCare and Fairview Southdale Hospital to improve patient care and experience, and reduce costs. While the pilot intervened with all admitted UCare for Seniors patients in the group, efforts targeted those with diabetes, chronic obstructive pulmonary disease and heart disease.
In results through September, 27 patients were readmitted to Fairview Southdale out of 292 original admissions among the group. The 9.25 percent readmission rate compares to a 16.5 percent readmission rate to the same hospital in 2009 among a similar population.
The project has reduced between 30 and 44 percent of readmissions, “depending on how you measure and define the readmissions,” says William Nersesian, MD, MHA, chief medical officer, Fairview Physician Associates. FPA is an Edina-based network of 1,200 independent, Fairview employed and University of Minnesota primary and specialty physicians.
Keeping patients healthy and costs down
While some patients will need to be readmitted to the hospital, preventing avoidable readmissions keeps patients healthy and holds costs down. Each prevented readmission could save $10,000 in avoidable cost, Nersesian says. Extended across all Fairview hospitals and insurance payers, the project could save several million dollars, he adds.
“The early results exceed our original hope of a 20 percent reduction in readmission,” says Nersesian, Nationally, 20 percent of hospitalized Medicare patients are readmitted within 30 days of discharge, he says.
Expanding the pilot to other Fairview hospitals
As a result of the success, Fairview Ridges Hospital adopted the project Nov. 1.
“Our long-term goal is to extend the project to other hospitals and other payers so that primary care doctors get paid well for a thorough visit which enables them to do what they do best: keep patients healthy and out of the hospital,” says Nersesian.
“The early success of this pilot project demonstrates the difference that swift follow up with recently discharged patients can make,” says Barry Baines, MD, associate medical director, UCare. UCare is an independent, nonprofit health plan serving more than 200,000 members enrolled in Minnesota Health Care Programs and Medicare across Minnesota and western Wisconsin.
Key interventions helped drive the results, including efforts by FPA nurse case managers, hospital social workers, hospitalists, medical records and pharmacists. Together they worked to prevent misunderstanding about medications, lack of self-care awareness, barriers to follow up clinic visits and other common reasons causing patients to be readmitted.
For example, a patient with diabetes and heart failure returns home after a hospital stay for shortness of breath and heart-failure related weight gain. At home the patient may not have a family members available to help him take his medications correctly, eat the right foods and weigh himself to check for fluid retention. He could miss warning signs that might land him back in the hospital.
“Everyone in the health care system benefits when patients make a successful transition from the hospital and become empowered to take better care of themselves,” Baines says.
For more about FPA and its mission to improve the health of communities, visit fpanetwork.org.
For more about UCare,visit ucare.org.