TRENTON — The rate of Medicare patients in New Jersey cycling in and out of hospitals last year declined by 7.5 percent since 2010 — probably because doctors, visiting nurses, nursing homes and social service agencies are working together to prevent unnecessary readmissions, according to federal data released today by a health care research firm.
The data show that at the end of 2010, 21.6 percent of hospitalized New Jersey Medicare patients were readmitted 30 days after discharge, but by the end of 2012 the figure had dropped to 19.98 – an improvement of 7.5 percent, according to Healthcare Quality Strategies of East Brunswick, a firm hired by the federal government to improve the quality and efficiency of New Jersey’s Medicare and Medicaid programs.
Readmission rates among Medicare patients from Hunterdon, Sussex and Warren counties ranked the lowest, or best, while Hudson, Essex and Salem counties ranked the highest, or worst, according to the data.
The collaboration between hospitals and other health care providers is driven by necessity. Since Oct. 1, the federal government has withheld as much as 1 percent of all Medicare reimbursements from hospitals if patients returned within 30 days of discharge. When the next federal fiscal year starts on Oct. 1, penalties will rise to 2 percent, then 3 percent the following year, under the Affordable Care Act.
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“Nearly every hospital in New Jersey is being penalized, so it makes sense to pay attention,” said Andrew Miller, the medical director for Healthcare Quality Strategies. He shared the data at a conference on hospital readmissions held at the New Jersey Hospital Association headquarters in West Windsor today.
“This is good for patients. You don’t want to be in the hospital if you don’t need to be,” Miller said. “This is about better quality at lower cost. Nobody is saying keep people out of the hospital who need to be there.”
Miller’s organization is permitted to release readmission data from the U.S. Centers for Medicare and Medicaid Services only by county at this time. But the information should be useful for the public because it gives people a sense of the strength of the health care services in their surrounding area.
“This is not just about the hospital, it’s about where the patient lives,” Miller said.
“The measure is hospital readmissions, but (hospitals) are dependent on hospice providers, visiting nurses, physician practices, county offices of aging, and mental health providers. They are even starting to involve pharmacists who manage a patient’s medication.”
Hospital discharge planners are starting to talk to nursing homes or family doctors in advance of a patient’s discharge to discuss what follow-up care the patient needs to recover, Miller said. “There is communication – it’s not perfect yet – but it is happening.”
Hospitals are starting to have frank discussions with nursing home operators about whether they can be counted on to provide the follow-up care a patient requires. , “Hospitals are saying if these patients come back it’s gong to hurt us and it’s not good for our patients. We expect you will do things that will keep them healthy.”
Monmouth County hospitals saw the biggest drop in readmissions, moving from 14th lowest in 2010 to 6th lowest in 2012, according to the data. Passaic County saw the biggest increase, going from fourth lowest in 2010 to 18th last year.
Date: June 13, 2013