Issue link: https://beckershealthcare.uberflip.com/i/267523
40 Financial Management P atients might leave the hospital with dis- charge instructions to ensure they stay on the mend, but there's plenty that could go wrong once they get home. Medication, for instance, can prove problematic, says Kathy Donofrio, associate vice president of nursing and director of cardiology at Swedish Covenant Hospital in Chicago. "Patients have a tendency to worry about fi- nances, so they save their medications," she says. "We actually have patients who went home with generic medication…at home they had the brand name and took both. They were double-dosing themselves. Then they're back in the ER because their blood pressure is low because they took the same medication twice." Because of scenarios like that, between July 2011 and June 2012, Swedish had an overall 30-day Medicare patient readmission rate higher than the national average of 16 percent. However, since then, Swedish has implemented a care transition program, funded by grants from organizations like the Retirement Research and Ackerman foun- dations. The initiative involves interventions like home visits from wellness coaches who help clear up confusion about medications. During the first 10 months of 2013, the safety-net provider's read- mission rate dropped to 14.25 percent. Aside from the desire to improve outcomes for patients, Ms. Donofrio says the hospital was mo- tivated by the threat of penalties for high readmis- sion rates under the Medicare Hospital Readmis- sions Reduction Program. The program, which began in fiscal year 2013, incentivizes hospitals across the nation to reduce preventable readmis- sions by cutting Medicare payments for those with rates deemed unacceptably high. This Octo- ber, reducing readmissions will become an even more urgent objective for hospitals as the poten- tial reimbursement reductions get bigger and the list of conditions CMS scrutinizes gets longer. More risk for hospitals: What readmissions reduction will look like in FY 2015 The readmissions reduction program, which was established by the Patient Protection and Afford- Focusing on the Patient, Not the Condition: What Hospitals Need to Know About Avoiding Medicare Readmission Penalties By Helen Adamopoulos