Heart Failure Readmissions: A Case Study

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The readmissions program, created under the Affordable Care Act, initially evaluated how often patients treated for heart attack, heart failure and pneumonia had to return to the hospital within 30 days of discharge. For fiscal 2015 the CMS added treatment for two conditions—chronic obstructive pulmonary disease and total hip and total knee replacements—and the penalty rose to 3%. The CMS data from January to December 2016 revealed that Emory University Hospital in Atlanta, Georgia had higher rates of readmission back to the same hospital than the state and national by 2.72% and 0.98%, respectively. Emory University Hospital was the top discharging hospital by volume in Atlanta for Medicare inpatients, and the third highest in the state.
Reasons
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Readmissions were highest among Medicare patients at more than 55 percent. Follow-up appointments, medications, and other appropriate actions are taken to reduce readmissions. Emory’s ongoing quality improvement efforts include several programs to ensure that when their patients are discharged, they have a clear understanding of what they need to do, how to get medical help if needed and when to see their physicians in follow up. Heart failure readmission rates. Findings suggest that the nurse-led evidence-based HF education program improved self-care behaviors and decreased 30-day readmissions. Healthcare workers must identify effective interventions to reduce readmission of patients with heart failure while providing high-quality care. These actions were successful in the decrease of readmissions to the hospital. Preventing readmissions is good for both patients and hospitals, which face reimbursement penalties from Medicare and Medicaid when patients with certain conditions are readmitted within 30 days. The readmission rates for those with advanced heart failure is down 33% at Emory University Hospital

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