Readmission Fines "Changing Culture" Of Ohio Hospitals
Hospital officials believe new fines tied to higher readmission rates are changing the culture of health care. âIt is no exaggeration to say that we are working with them to transform the model of health care delivery," says Bruce Vanderhoff, senior vice president and chief medical officer for OhioHealth, a network of 17 hospitals in the Columbus area and around central Ohio. The transformation heâs talking about was sparked by a provision of the Affordable Care Act, also known as ObamaCare, which penalizes hospitals with high readmission rates. With a possible cut to Medicare reimbursement on the line, medical facilities around the country are thinking of new ways to make sure patients donât need to come back for additional treatment. Like many other hospitals around the state, OhioHealth placed an emphasis on patient education, making sure they know everything about their treatment and medication before they walk out the door. Vanderhoff says itâs also important to identify which patients are at a higher risk of readmission. Hospitals do this by providing health coaches who visit patientsâ homes and help further their treatment. Follow-up phone calls, pharmacy consultations, and in-depth meetings with a patientâs family are also used in the process. âIâm always impressed by how energetically our nurses and doctors and respiratory therapists and othersâour pharmacistsâhave engaged in that good work, Vanderhoff says, "because they have to help the patients understand their medicationâunderstand their treatment plan.â? OhioHealth serves a widearea which includes many urban communities. But what about the stateâs rural areas? Berger Health System has a hospital in Circleville which serves a smaller population. Tim Colburn, president and CEO, says this can sometimes be a good thing. âSo our physicians probably know our patients a bit closerâmore intimately. Our health care providers inside the hospital know their patients better so we get that interactiveâpersonal relationship to impact an individual or a patientâs behavior.â? Keith Holten, chief medical officer for Berger, admits there are some unique challenges when it comes to reducing readmissions as a smaller establishment, but says thatâs no excuse. âInstead of being a challengeâas an organization we view this as an opportunity to be innovative and to think outside the box because of our size," Holten says. Both Holten and Colburn echoed Vanderhoffâs belief that the effort to bring down readmission rates has helped redefine the culture of health care, with community engagement as the cornerstone. âOne of the important transitions thatâs occurring in health care is for all of us to understand that we care for a population and a community of patients, instead of taking care of them in the hospital," Holten says. "And many of the things that we have done are helping us to move in a direction of managing the populationâs instead of their diseases.â? The officials from OhioHealth and Berger Health Systems say the foundation for readmission reduction has been established in the first year of the provision and believe their rates will continue to decline as the roots of their policies settle in.