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Northeastern Employers to Hospitals: Enough with the Avoidable Readmissions

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A think tank affiliated with the Northeast Business Group on Health has tried to come up with ideas for tackling a problem that drives up health care costs while reducing the quality of care: Boomerang patient syndrome.

Health policy analysts assume that a high percentage of patients who are discharged from a hospital and return within 30 days either had conditions that were not properly addressed when they left the hospital or did not receive proper followup care.

Shawn Nowicki and other analysts who helped develop the report for the NEBGH, New York, note that the overall 30-day readmission rate is high across the United States, and especially high in the Northeast.

“The New York metro region’s poor performance in readmission rates is particularly alarming,” the analysts write.

When the Commonwealth Fund, New York, created a 2009 hospital readmissions scorecard, Connecticut ranked 32nd, New Jersey ranked 48th, and New York came in dead last, the analysts say.

About 12.7% of all U.S. patients discharged after surgery returned within 30 days in 2009.

The surgical readmission rate was 13.3% in Connecticut, 14.9% in New Jersey and 15.9% in New York.

The NEBGH think tank developed the hospital readmissions report by asking hospitals, health plans, employers and other stake holders for their ideas about how to fix the problem.

Employers said they believe hospitals and health plans are doing too little to work together to reduce readmission rates, the analysts say.

Experts said the main obstacle to a partnership is that hospitals and plans have been feuding for years. But the experts said they think hospitals and plans are now starting to get serious about finding common ground.

Employers also complained that employees are not aware that high hospital readmission rates is a problem, the analysts say.

Reaching out to employees is difficult, in part because employees tend to distrust health plans, the analysts say.

Experts told the NEBGH panel that “employers should engage with employees before they become ill, provide tools to help them understand how their health plans work, and inform employees of changes in how their care will be administered,” the NEBGH analysts say.

If employers are going to reach out to employees more effectively, the plans have to do a better job of getting employers readmissions data and other wellness program outreach and performance data, the analysts say.

Employers “experience coding and reimbursement problems with their health plan regarding whether outreach services are defined as a wellness/preventive benefit or a tactic specific to a readmissions reduction initiative, and thus whether to selectively target outreach efforts or to apply them broadly,” the analysts say.