Make Reducing Readmission Rates a Priority For Your Organization
The implementation of the Affordable Care Act more than a decade ago was supposed to lead to a more modern outcome-based healthcare system instead of the traditional fee-for-service model. One way thought leaders devised for measuring outcomes was to look at readmission rates. So how is your organization doing in this regard?
We believe it is important to make reducing readmission rates a priority within behavioral health. We are not alone. Mental health consulting companies around the country work with clients to reduce readmission rates, knowing that doing so means better outcomes for patients and better financials for providers.
Readmission Is Common in Mental Health
Across the board, mental health conditions are associated with a higher than average readmission rate. Roughly 8% of all mental health patients discharged from hospitals are readmitted within 30 days. Indeed, some conditions have higher readmission rates than others.
An estimated 15% of mood disorder patients are readmitted within that 30 day window. More than 22% of schizophrenia patients are readmitted.
High readmission rates have been attributed to multiple factors, including:
- comorbidities (esp. substance use disorders)
- poor medication management
- improper or poor quality treatment
- lack of adequate patient follow-up
- lack of adequate transitional care
There doesn’t seem to be a single factor to which most readmissions can be attributed. That makes reducing readmission rates a bigger challenge. Success requires taking a close look at how an organization operates in hopes of identifying a number of little things that all add up to higher readmissions.
Why It Matters to Patients
Reducing readmission rates translates into better outcomes. Better outcomes matter to patients because they impact everything from quality of life to overall behavioral well-being.
By working to reduce readmission rates, organizations can help patients:
- prevent further declines in their health
- work to strengthen personal relationships
- find and maintain stable employment
- reduce the risk of homelessness
- reduce the risk of suicide
On the other hand, not reducing readmission rates means settling for less than the best possible outcomes. When organizations do so, they make it more difficult for patients to live the best life possible in a world they often find challenging.
Why It Matters to Organizations
Reducing readmission rates matters to organizations on two distinct levels. In terms of quality of care, higher readmission rates harm an organization’s reputation. A poor reputation can make it more difficult to increase patient loads. That can have a profound effect on revenue.
Taken to the next level, higher readmission rates can have an impact on value-based reimbursements. As you probably already know, CMS doesn’t think too highly of behavioral health organizations with high readmission rates. They have been known to assess financial penalties against such organizations.
Fee-For-Service on Its Way Out
Despite outcome-based healthcare not catching on as fast as lawmakers had hoped a decade ago, it is slowly being implemented. Conversely, the fee-for-service model is on its way out. It will be completely eliminated at some point. That is reason enough for organizations to work harder on reducing readmission rates.
As mental health consulting experts, Horizon Health can partner with your organization to reduce readmission rates. We can work with you to examine your policies, procedures, treatments, etc. to better understand why your readmission rates are higher than they should be. With that understanding, we can work with you to find solutions.
Reducing readmission rates should be a priority for all behavioral health providers. Doing so means better outcomes for patients. That translates into better business, increased revenues, and a financially stronger organization. All are goals worth pursuing within the behavioral health space.